Methotrexate has been around for decades and is relatively safe or doctors would not be prescribing it. The idea is to get off the steroids which have a multiplicity of issues long term. The Methotrexate is not meant (in so far as I understand) for long term. One needs monthly lab work to monitor liver functions tests in particular. Patients have rights. Your doctor should be explaining the reasoning behind not prescribing it for you. Perhaps you have a co-morbidity? But do get your doctor to explain. What will work for one person won’t necessarily work for someone else (as in the above post). It is about quality of life. Risk/benefit of any drug be it long term or short. I wish you well.