revamilast + methotrexate

**Revamilast + methotrexate** is a combination therapy for inflammatory autoimmune disorders, primarily rheumatoid arthritis and possibly psoriasis. Revamilast is a selective phosphodiesterase 4 (PDE4) inhibitor, acting as a novel oral anti-inflammatory agent. Methotrexate is a conventional disease-modifying antirheumatic drug (DMARD) that inhibits dihydrofolate reductase, impacting purine/pyrimidine synthesis and immune function. Combination therapy that includes a PDE4 inhibitor (such as apremilast, which has a mechanism analogous to revamilast) and methotrexate has been shown to have no significant pharmacokinetic drug-drug interaction. This type of combination is being developed to improve clinical outcomes in patients who do not achieve sufficient disease control with methotrexate monotherapy.