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Combination therapy of **peficitinib** (a small molecule Janus kinase [JAK] inhibitor) and **methotrexate** (a conventional synthetic disease-modifying antirheumatic drug [csDMARD]) is used in the treatment of moderate-to-severe rheumatoid arthritis (RA), particularly in patients with inadequate response to methotrexate alone. Peficitinib targets JAK enzymes to inhibit inflammatory signaling, reducing immune-driven joint damage. Methotrexate acts as an immunosuppressant and anti-inflammatory by inhibiting dihydrofolate reductase, interfering with DNA synthesis and cell proliferation in immune cells. This combination has shown efficacy in improving clinical outcomes and reducing disease activity in RA, with a manageable safety profile.[1][2][4]
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