Crohn's & MS, most drs and insurance companies are going to prefer you try methotrexate first. It is much cheaper, has many more years of research to back it up and, although I know all drugs have risks, is probably overall safer. I don't know how Tsyabri is given, but methotrexate is normally taken by mouth once a week (can be injected if you have side effects to the oral). I just started it recently and have had no side effects that I've noticed. I'm on it for my arthritis.