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Methotrexate is an antimetabolite and immunosuppressant that inhibits enzymes responsible for nucleotide synthesis, thereby reducing cell division and inflammation. It is widely used in rheumatoid arthritis, psoriasis, and certain cancers[6][9]. Zoledronic acid is a bisphosphonate that inhibits osteoclast function, preventing bone resorption. It is used to treat osteoporosis, hypercalcemia of malignancy, multiple myeloma, and bone metastases from solid tumors[5]. The combination of methotrexate and zoledronic acid has been studied for its potential to prevent both bone erosion (via anti-inflammatory effects) and systemic bone loss (via direct osteoclast inhibition), particularly in models of rheumatoid arthritis[1]. In clinical trials for advanced cancer with bone involvement (e.g., osteosarcoma), this combination has also been explored alongside other agents such as cyclophosphamide and sirolimus[3][7].
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