mycophenolate mofetil + rituximab

Mycophenolate mofetil + rituximab is a combination therapy consisting of two immunosuppressive agents used primarily in the management of autoimmune and inflammatory diseases, particularly interstitial lung disease (ILD) associated with connective tissue disorders, systemic sclerosis (SSc), nephrotic syndrome, and neuromyelitis optica spectrum disorder (NMOSD). Mycophenolate mofetil is a prodrug that inhibits inosine monophosphate dehydrogenase, suppressing T- and B-cell proliferation by blocking de novo purine synthesis. Rituximab is a monoclonal antibody targeting CD20 on B lymphocytes, leading to their depletion. The combination aims to provide synergistic immunosuppression by targeting both T-cell and B-cell mediated pathways. Clinical studies have shown this regimen can improve pulmonary function in ILD/NSIP patterns, reduce skin fibrosis in SSc, maintain remission in nephrotic syndrome, and decrease relapse rates in NMOSD[1][2][3][4][5][10].