 The management of RA rests on several principles; drug treatment, which comprise disease modifying anti-rheumatic drugs DMARDS, but also non-steroidal anti-inflammatory drugs NSAIDs and glucocorticoids GCs, as well as non-pharmacological measures, such as physical, occupational and psychological therapeutic approaches, together may lead to therapeutic success. However, the mainstay of RA treatment is the application of DMARDs. Methotrexate MTX is the anchor drug in the management of RA and has been used for many decades. 