cyclophosphamide + azathioprine + prednisolone

This cytotoxic combination therapy is a multi-drug immunosuppressive regimen used as a standard-of-care or control arm in clinical trials for Behcet's disease, particularly for resistant ocular manifestations such as retinal vasculitis and posterior uveitis. The regimen consists of three primary components: pulse cyclophosphamide (an alkylating agent), azathioprine (a purine synthesis inhibitor), and prednisolone (a corticosteroid). Cyclophosphamide works by cross-linking DNA to inhibit cell division, azathioprine acts as a prodrug that interferes with purine metabolism to suppress T and B cell proliferation, and prednisolone provides broad anti-inflammatory effects by activating glucocorticoid receptors. In a Phase 2 pilot study conducted by the Tehran University of Medical Sciences (NCT00700297), this combination was used as the comparator arm against rituximab in patients with ocular lesions resistant to conventional therapy.

Other names

Cytotoxic Combination