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The combination of methylprednisolone and methotrexate is used for its synergistic anti-inflammatory and immunosuppressive effects. Methylprednisolone is a synthetic glucocorticoid that suppresses inflammation by inhibiting the migration of polymorphonuclear leukocytes, reversing increased capillary permeability, and suppressing the immune system. Methotrexate is an antimetabolite that inhibits dihydrofolate reductase, thereby interfering with DNA synthesis, cell replication, and immune function. Together, this combination has shown improved efficacy in conditions such as bullous pemphigoid (enabling rapid glucocorticoid tapering) and in experimental models of spinal cord injury (enhancing neuroprotection by reducing inflammation and apoptosis)[1][3].
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