budesonide + ursodeoxycholic acid

**Budesonide + ursodeoxycholic acid** is an oral combination therapy used primarily in the management of autoimmune liver diseases, particularly primary biliary cholangitis (PBC) and PBC-autoimmune hepatitis (AIH) overlap syndrome. Budesonide is a synthetic glucocorticoid with extensive first-pass hepatic metabolism, reducing systemic steroid side effects. Ursodeoxycholic acid (UDCA) is a hydrophilic bile acid that improves cholestasis and has cytoprotective, immunomodulatory, and choleretic actions. The combination aims to improve liver function and reduce histological disease progression more effectively than UDCA alone in non-cirrhotic patients. Clinical evidence suggests superior histological and biochemical response with the combination compared to monotherapy, though budesonide’s use is limited in cirrhosis due to potential safety concerns[1][2][3][4][5].