rituximab + methotrexate + corticosteroids

A combination regimen of **rituximab**, **methotrexate**, and **corticosteroids** is used primarily in the treatment of autoimmune diseases such as rheumatoid arthritis and some vasculitides, as well as select lymphomas. **Rituximab** is a chimeric monoclonal antibody targeting the CD20 antigen on B lymphocytes, leading to B-cell depletion. **Methotrexate** is a folate antimetabolite and antineoplastic agent, acting primarily as a dihydrofolate reductase inhibitor, impairing DNA synthesis and cellular replication. **Corticosteroids** (most commonly glucocorticoids like methylprednisolone or prednisone in this context) are anti-inflammatory and immunosuppressive agents that act via the glucocorticoid receptor, influencing gene expression to suppress immune responses. This combination is highly effective in reducing disease activity, clinical symptoms, and progression of joint or tissue damage, offering synergistic effects for refractory or moderate-to-severe disease states[1][2][3][4][5][8].