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This combination regimen consists of the oral anticoagulant rivaroxaban and a standard immunosuppressive backbone of azathioprine and methylprednisolone. It is currently being evaluated in a Phase III clinical trial led by Marmara University for the treatment of lower extremity venous thrombosis in patients with Behçet's Disease. Rivaroxaban is a small molecule direct Factor Xa inhibitor that prevents blood clot formation by blocking a key enzyme in the coagulation cascade. Azathioprine is an immunosuppressive antimetabolite that inhibits purine synthesis, while methylprednisolone is a corticosteroid that exerts anti-inflammatory effects via the glucocorticoid receptor. The regimen aims to address both the thrombotic complications and the underlying systemic vasculitis associated with Behçet's Disease.
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