methotrexate + prednisolone + salazosulfapyridine

This is a combination therapy consisting of three drugs—methotrexate, prednisolone, and salazosulfapyridine (also known as sulfasalazine)—used primarily in the management of rheumatoid arthritis and other inflammatory autoimmune diseases. Methotrexate is a folic acid antagonist that inhibits dihydrofolate reductase, leading to immunosuppressive and anti-inflammatory effects. Prednisolone is a synthetic glucocorticoid corticosteroid with potent anti-inflammatory and immunosuppressive properties, acting through glucocorticoid receptor agonism to suppress multiple inflammatory pathways. Salazosulfapyridine (sulfasalazine) is a disease-modifying antirheumatic drug (DMARD) that exerts its effect by modulating immune responses and reducing inflammation; it is metabolized into 5-aminosalicylic acid (mesalamine) and sulfapyridine in the colon. This triple combination targets different aspects of the immune response to achieve better control of disease activity than monotherapy or double therapy regimens[1][2][3]. The regimen may be used when single or dual DMARD therapy fails to adequately control symptoms.