Cyclosporine has now been tested in over 10 clinical trials in Rheumatoid Arthritis. These show that it provides clinically important benefit in 30-50% of patients with severe rheumatoid arthritis with an acceptable side-effect profile. It should be offered to patients who fail to (or only partially respond to methotrexate. The use of Cyclosporine in combination with other slow acting agents shows promise and should be tested at different points in the natural history of the disease.