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This is a combination therapy of four conventional disease-modifying antirheumatic drugs (DMARDs) used primarily for treating rheumatoid arthritis and other autoimmune conditions. The combination includes methotrexate (the anchor drug in RA treatment), leflunomide (a pyrimidine synthesis inhibitor), sulfasalazine (an anti-inflammatory agent), and hydroxychloroquine (an antimalarial with immunomodulatory properties). This multi-DMARD approach is used when single DMARD therapy is insufficient to control disease activity. The combination works through different mechanisms to suppress the immune system, reduce inflammation, prevent joint damage, and slow disease progression.
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