Methotrexate: anti-inflammatory or immunosuppressive?

Low dose methotrexate (MTX) is an effective drug for rheumatoid arthritis, suppressing joint inflammation and even radiographic progression of joint disease. Some disease-specific side effects suggest an immunomodulatory effect of the drug. However, most data currently available suggest a mechanism of action at the level of the non-specific efferent arc of the immuno-inflammatory process rather than on T cells.