rituximab + tacrolimus + mycophenolate mofetil

This is a combination immunosuppressive regimen consisting of three agents with distinct mechanisms of action, commonly used in the management of autoimmune diseases and for prevention or treatment of organ transplant rejection. **Rituximab** is a monoclonal antibody targeting CD20 on B lymphocytes, leading to B cell depletion and reduced autoantibody production. **Tacrolimus** is a calcineurin inhibitor that suppresses T-cell activation by inhibiting the phosphatase activity of calcineurin, thereby reducing interleukin 2 transcription and T-cell proliferation. **Mycophenolate mofetil** is an inosine monophosphate dehydrogenase inhibitor that blocks de novo purine synthesis in lymphocytes, impairing both T and B cell proliferation. This triple therapy has been studied for use in refractory lupus nephritis, nephrotic syndrome, membranous nephropathy, and other severe autoimmune conditions where standard therapies have failed or are insufficient[1][2][3][5]. Each drug contributes synergistically to immunosuppression via different pathways.

Other names

RTX (for rituximab)FK506 (for tacrolimus)MMF (for mycophenolate mofetil)