rituximab + tocilizumab

Rituximab + tocilizumab is a combination of two monoclonal antibody biologic drugs used experimentally for the treatment of autoimmune diseases, particularly in patients with rheumatoid arthritis (RA) or systemic sclerosis-interstitial lung disease (SSc-ILD) who have not responded adequately to standard therapies. Rituximab is a chimeric monoclonal antibody targeting CD20 on B cells, leading to B cell depletion and reduced autoantibody production. Tocilizumab is a humanized monoclonal antibody that inhibits the interleukin-6 receptor (IL-6R), blocking IL-6-mediated pro-inflammatory signaling involved in immune activation and tissue damage. The combination aims to provide additive or synergistic immunosuppressive effects by targeting both B cell activity and IL-6-driven inflammation. Clinical studies have evaluated this combination primarily in RA patients with incomplete response to methotrexate, as well as in SSc-ILD refractory cases, but it is not an approved or standard therapy due to concerns about safety and increased risk of infection[3][4][5].