New treatment for Chronic Hepatitis B

15 January, 2023

Chronic hepatitis B virus infection is a global health problem.

Approximately 1.5 million new infections and 820,000 deaths occur each year (predominantly from cirrhosis and liver cancer) due to chronic hepatitis B.

There are drugs against hepatitis B (entecavir, tenofovir) that are very effective in inhibiting the replication of the virus but that do not achieve its complete elimination, that is, the loss of the surface antigen of the hepatitis B virus (HBsAg). For this reason, they must be administered indefinitely, since when treatment is suspended, a relapse occurs. Thus, less than 5% of treated patients lose HBsAg each year (cure) and therefore, development of other more effective drugs is necessary.

How does the new drug work?

A study has been published in the New England Journal of Medicine in which patients with chronic hepatitis B have been treated with a new drug that is an antisense probe (Bepirovirsen) that can effectively inhibit the multiplication of the B virus. Total of 457 patients were treated with different doses of Bepirovirsen (150-300 mg) administered by subcutaneous injection one day a week for 24 weeks. A control group that received placebo for the same period of time was also included.

It was shown that between 9-10% of the patients treated with 300 mg of the drug presented a complete response (maintained loss of HBsAg and B virus DNA), that is, a cure. Side effects were injection arm pain, redness, and pruritus in 48-73% of patients.

A promising future

In summary, Bepirovirsen is a drug with very promising results for the cure of chronic hepatitis B and studies are being carried out combining Bepirovirsen with other therapies (pegylated interferon, vaccine, PAPD5 and PAPD7 enzyme inhibitors) to increase the efficacy of the drug treatment. Therefore, the future for the complete cure of chronic hepatitis B with new drugs is very hopeful.

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