tocilizumab + sulfasalazine

**Tocilizumab + sulfasalazine** is a combination of two disease-modifying antirheumatic drugs (DMARDs) used in the treatment of autoimmune and inflammatory diseases, especially **rheumatoid arthritis**. Tocilizumab is a humanized monoclonal antibody that specifically binds to soluble and membrane-bound interleukin-6 receptors (IL-6R), thereby inhibiting IL-6-mediated inflammatory signaling[1][2][3][5][6][7]. Sulfasalazine is a synthetic DMARD whose precise mechanism is not fully understood, but it is known to inhibit transcription factor nuclear factor kappa-B (NF-kB), suppress TNF-α expression, inhibit osteoclast formation through RANKL suppression, and modulate adenosine-mediated anti-inflammatory pathways[1][4]. This combination is often used in patients who have an inadequate response to other DMARDs and has demonstrated increased efficacy in reducing articular and systemic symptoms of rheumatoid arthritis when compared to monotherapy[5]. Tocilizumab can be given intravenously or subcutaneously[5], while sulfasalazine is administered orally[1][4]. Both drugs have different risk profiles and mechanisms, which allows for synergistic therapeutic action.