abatacept + mycophenolate mofetil + prednisone

This is a combination regimen consisting of **abatacept** (a selective T-cell co-stimulation modulator), **mycophenolate mofetil** (a prodrug immunosuppressant that inhibits inosine monophosphate dehydrogenase), and **prednisone** (a synthetic glucocorticoid corticosteroid). The regimen is used off-label for severe or refractory autoimmune and inflammatory diseases, particularly where escalation of immunosuppressive therapy is required (e.g., steroid-refractory immune-related myocarditis, refractory inflammatory myopathies, and certain vasculitides). Abatacept blocks CD80/CD86-mediated co-stimulation of T cells; mycophenolate mofetil inhibits de novo guanosine synthesis critical for lymphocyte proliferation; and prednisone broadly suppresses immune response via glucocorticoid receptor agonism. The combination is not an approved or marketed fixed-dose or branded product, but is described in the literature for clinical use where enhanced, multimodal immunosuppression is needed[2][7].