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Prednisone + leflunomide is a combination of two immunosuppressive agents used primarily in the management of autoimmune diseases such as myasthenia gravis, primary membranous nephropathy, and immune-mediated polyarthritis. Prednisone is a synthetic glucocorticoid that exerts anti-inflammatory and immunosuppressive effects by modulating gene expression through the glucocorticoid receptor, leading to decreased production of pro-inflammatory cytokines. Leflunomide is a disease-modifying antirheumatic drug (DMARD) that inhibits dihydroorotate dehydrogenase, an enzyme involved in de novo pyrimidine synthesis required for lymphocyte proliferation. The combination targets both T-cell and B-cell mediated immune responses, resulting in reduced inflammation and autoantibody production. This regimen has demonstrated efficacy in reducing disease activity scores and improving clinical symptoms with an acceptable safety profile[1][3][4][5].
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