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Methotrexate + upadacitinib is a combination therapy used primarily for the treatment of moderate to severe rheumatoid arthritis, particularly in patients who have had an inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). Methotrexate is a folate antimetabolite that inhibits enzymes involved in nucleotide synthesis, leading to anti-inflammatory and immunosuppressive effects. Upadacitinib is a selective Janus kinase 1 (JAK1) inhibitor that disrupts the JAK-STAT signaling pathway, thereby reducing pro-inflammatory cytokine signaling. The combination has demonstrated greater clinical efficacy than placebo plus csDMARDs and is recommended for patients with active rheumatoid arthritis not adequately controlled by other therapies[1][2][4].
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