Hi, Thanks for posting in HCM. I understand your concern. Methotrexate acts by interfering with the growth of certain cells of the body, especially cells that reproduce quickly, like cancer cells, bone marrow cells and skin cells. Hence, it is used to treat certain types of cancer of the breast, skin, head and neck or lung. However, it is also used to treat severe psoriasis and rheumatoid arthritis. It is not known exactly how methotrexate works in rheumatoid arthritis, but it can reduce inflammation and slow the progression of the disease. Hence, methotrexate is considered to be a disease-modifying antirheumatic drug . Most rheumatologists, that s why, use methotrexate as first-line therapy. Kindly take the medications as advised and do the necessary follow-up as suggested. Hope the information provided would be helpful. All the best and wish you good health. Regards, Dr. Ashakiran.S., MBBS., MD.