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Any healthcare provider considering this combination should document their clinical rationale, obtain informed consent discussing the off-label nature of the combination, and establish a monitoring plan that includes regular assessment of cardiovascular parameters, mental health status, and treatment response

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Pathways related to immunoglobulin, production, defense responses and B cell activation were among those downregulated, including immunoglobulin production ( IGKV112 , IGKV117 ), adaptive immune response (for example, CX3CR1 , FCGR1BP ) and B cell activation ( HDAC9 , CD180 , MNDA ) (Extended Data Fig