The antirheumatic agents sulphasalazine and methotrexate share an anti-inflammatory mechanism

Increasingly, methotrexate (MTX) and sulphasalazine (SASP) are used initially for second-line therapy of rheumatoid arthritis (RA). Although SASP and MTX are commonly used, the mechanism(s) by which these drugs control the inflammation that characterizes RA have remained obscure. Results from my laboratory indicate that these agents share a mode of action; the anti-inflammatory effects of both SASP and MTX are due, in both in vitro and in vivo studies, to their capacity to enhance adenosine release at inflamed sites. This mode of action suggests that the development of agents that directly alter adenosine metabolism may lead to new, more effective and safer antirheumatic drugs than those currently available.