prednisone + mycophenolate mofetil + rituximab

This is a **combination therapy** consisting of three distinct drugs: prednisone, mycophenolate mofetil, and rituximab. Each component functions through different mechanisms to provide immunosuppression and anti-inflammatory effects, primarily used in the management of autoimmune diseases (such as systemic lupus erythematosus and vasculitis) and sometimes in organ transplantation. - **Prednisone** is a synthetic glucocorticoid that acts as an immunosuppressant and anti-inflammatory agent by decreasing the transcription of pro-inflammatory genes through binding to the glucocorticoid receptor. - **Mycophenolate mofetil** is a small molecule immunosuppressant that inhibits inosine monophosphate dehydrogenase (IMPDH), thereby blocking de novo purine synthesis in lymphocytes and reducing T and B cell proliferation. - **Rituximab** is a chimeric monoclonal antibody (IgG1) that targets the CD20 antigen on pre-B and mature B lymphocytes. Binding to CD20 triggers several mechanisms of B-cell depletion: complement-dependent cytotoxicity (CDC), antibody-dependent cell-mediated cytotoxicity (ADCC), direct induction of apoptosis, and immunomodulatory effects that reduce inflammation and autoantibody production[1][2][3][4][5][6][7]. The combination provides additive and synergistic immunosuppressive mechanisms, commonly used for refractory autoimmune conditions and certain transplant regimens.