upadacitinib + methotrexate + tofacitinib

A combination regimen consisting of **upadacitinib**, **methotrexate**, and **tofacitinib**. This is not a single fixed-dose combination product, but rather the concurrent or sequential use of three disease-modifying antirheumatic drugs (DMARDs) in the treatment of moderate to severe rheumatoid arthritis. All three agents individually are oral small molecule DMARDs: upadacitinib and tofacitinib are Janus kinase (JAK) inhibitors (with upadacitinib being more selective for JAK1 and tofacitinib being a pan-JAK inhibitor), and methotrexate is a folate analog metabolic inhibitor that reduces immune cell proliferation and function. This combination would be used for autoimmune disorders where robust immunosuppression is needed, though it is not a standard or approved regimen, and combination of multiple JAK inhibitors with methotrexate poses high safety risk.

Other names

upadacitinib + methotrexate + tofacitinib