Rheumatoid arthritis is a chronic inflammatory disorder that has no cure.  It is an autoimmune disorder, in which the patient’s own immune system attacks its own tissues.  The goal is to quiet this attack, and put a halt to the inflammation.

The approach to rheumatoid arthritis in this country is to begin a patient on a so-called DMARD (disease-modifying antirheumatic drug).  If a patient has mild disease, then sulfasalazine is a reasonable drug to begin.  However, methotrexate appears to...