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This drug is a combination of three conventional disease-modifying antirheumatic drugs (DMARDs): methotrexate, sulfasalazine, and hydroxychloroquine. It is commonly referred to as "triple therapy" in the management of rheumatoid arthritis. Each component has a distinct mechanism of action: - Methotrexate inhibits dihydrofolate reductase and other folate-dependent enzymes, suppressing immune cell proliferation. - Sulfasalazine modulates inflammatory mediators and may inhibit prostaglandin synthesis. - Hydroxychloroquine interferes with lysosomal activity in antigen-presenting cells and modulates immune responses. The combination is more effective than monotherapy or double combinations for achieving remission or significant improvement in rheumatoid arthritis symptoms. Triple therapy is generally well-tolerated with side effects similar to those seen when each drug is used alone[1][2][7].
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