abatacept + rituximab + tocilizumab

This is not a single drug but a combination of three distinct biologic disease-modifying antirheumatic drugs (bDMARDs) used in the treatment of rheumatoid arthritis, particularly for patients with inadequate response to TNF inhibitors. Each drug works through a different mechanism:\n\n- **Abatacept** is a T-cell costimulatory blocking agent that inhibits T cell activation by binding to CD80/CD86 receptors on antigen-presenting cells, preventing their interaction with CD28 on T cells.\n\n- **Rituximab** is a B cell depleting agent that binds to the CD20 molecule on B cell surfaces, leading to B cell depletion from circulation.\n\n- **Tocilizumab** is an interleukin-6 (IL-6) receptor antagonist that binds to soluble and membrane-bound IL-6 receptors, preventing IL-6 mediated inflammation.

Brand names

Orencia + Rituxan + Actemra