Methotrexate (MTX) has been the anchor treatment in rheumatoid arthritis (RA) 
over the last 15 years, and is used in combination with biologic agents to 
enhance efficacy over the last decade or so. The safety profile of MTX has been 
studied over 25 years with very few clinically important adverse events in the 
weekly low-doses used for RA treatment. The importance of MTX in earlier and 
more aggressive management of RA patients cannot be overstated. MTX courses show 
some of the longest continuation rates reported in clinical medicine, due to 
both effectiveness and safety. The safety profile of MTX indicates that it is 
among the safest of any mediation used for the treatment of any arthritis. 
Better information on the effectiveness and safety of weekly-low dose MTX should 
be communicated to all health professionals involved in the management of RA 
patients.