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This entry refers to the combination therapy of a biologic disease-modifying antirheumatic drug (biologic DMARD) with a non-biologic (conventional synthetic) DMARD. Both classes are used to treat autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. Biologic DMARDs are protein-based drugs that target specific components of the immune system involved in inflammation, such as tumor necrosis factor (TNF), interleukins, or immune cell surface proteins. Non-biologic DMARDs—also called conventional synthetic DMARDs—are small molecules that broadly suppress immune activity and inflammation. Combination therapy is often used when monotherapy does not adequately control disease activity; for example, methotrexate (a non-biologic DMARD) is frequently combined with a TNF inhibitor like adalimumab or etanercept to enhance efficacy and reduce the risk of antibody formation against the biologic agent[1][2][3][4][5][6].
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