rituximab + cyclophosphamide + corticosteroids

This is a combination therapy consisting of rituximab (a monoclonal antibody targeting CD20 on B cells), cyclophosphamide (an alkylating agent and immunosuppressant), and corticosteroids (synthetic glucocorticoids with anti-inflammatory and immunosuppressive effects). The regimen is used primarily for remission induction in severe autoimmune diseases such as antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis and difficult-to-treat membranous nephropathy. Rituximab depletes B cells, cyclophosphamide targets rapidly dividing immune cells including plasmablasts/plasma cells, while corticosteroids broadly suppress inflammation. This combination allows for rapid disease control, reduced cumulative steroid exposure, and improved outcomes in patients with organ-threatening or refractory disease[1][2][3][4].