satralizumab + mycophenolate mofetil

A combination of **satralizumab**, a recombinant humanized monoclonal antibody targeting interleukin-6 (IL-6) receptors, and **mycophenolate mofetil**, an immunosuppressive small molecule. Satralizumab blocks both membrane-bound and soluble IL-6 receptors, inhibiting downstream JAK/STAT inflammatory signaling and reducing pro-inflammatory TH17 cells and B-cell activation. Mycophenolate mofetil is metabolized to mycophenolic acid, which inhibits inosine monophosphate dehydrogenase, suppressing lymphocyte proliferation and immune response. Both are used together for the prevention of relapses in neuromyelitis optica spectrum disorder (NMOSD), especially in aquaporin-4 IgG seropositive patients. The combination benefits from additive or synergistic immunosuppression by targeting complementary pathways implicated in the autoimmune pathogenesis of NMOSD[1][2][4][7].