azathioprine + mesalamine + prednisone

This is a combination therapy consisting of three pharmaceutical agents—azathioprine, mesalamine, and prednisone—commonly used in the management of inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis.

• Azathioprine is an immunosuppressive antimetabolite that inhibits purine synthesis, thereby reducing lymphocyte proliferation.
• Mesalamine (5-aminosalicylic acid) acts locally in the colon to reduce inflammation by inhibiting cyclooxygenase and lipoxygenase pathways, decreasing prostaglandin and leukotriene production.
• Prednisone is a synthetic glucocorticoid corticosteroid that suppresses inflammation by modulating gene expression to decrease pro-inflammatory cytokines.

The combination is typically used for patients with moderate-to-severe IBD who are steroid-dependent or refractory to monotherapy. Clinical reports indicate this triple therapy can induce remission in steroid-dependent ulcerative colitis and Crohn’s disease. The regimen leverages complementary mechanisms—immunosuppression from azathioprine, anti-inflammatory effects from both mesalamine and prednisone—to achieve better disease control than monotherapy.