prednisolone + ursodeoxycholic acid

This is a combination therapy consisting of prednisolone, a synthetic glucocorticoid corticosteroid, and ursodeoxycholic acid (UDCA), a hydrophilic bile acid. Prednisolone acts as an immunosuppressant and anti-inflammatory agent by modulating gene expression through the glucocorticoid receptor, thereby reducing immune-mediated liver inflammation. Ursodeoxycholic acid improves bile flow and protects hepatocytes from toxic bile acids by altering the composition of bile and exerting cytoprotective effects on cholangiocytes. The combination has been studied primarily for autoimmune liver diseases such as primary biliary cholangitis (PBC) and drug-induced liver injury (DILI), particularly in patients with insufficient response to monotherapy or with moderate to severe interface hepatitis characteristics. Clinical studies suggest that this combination can improve symptoms (such as pruritus, fatigue, arthralgia) and biochemical parameters (including alkaline phosphatase, AST, IgM) more effectively than either agent alone[1][2][8]. Ongoing trials are further evaluating its efficacy in PBC with moderate to severe interface hepatitis[2].