Bepirovirsen for the treatment of chronic hepatitis B infection

Chronic hepatitis B (CHB) virus infection is a significant worldwide medical problem. Functional cure is difficult to achieve with conventional antiviral therapy. Currently, many novel compounds are being developed, including bepirovirsen, an antisense oligonucleotide (ASO). This paper presents an updated summary of the chemistry, mechanism of action, pharmacokinetics, clinical efficacy and safety data collected from phase I and II studies of bepirovirsen in CHB infection. The reported data were obtained from abstracts of international conferences and journal articles published found in a PubMed search. Bepirovirsen, a 20-mer ASO, can lower HBsAg and HBV DNA levels and maintain them at undetectable levels even after treatment is finished. It is first ASO that entered the phase III study and the results are awaited. Although combinations of bepirovirsen with Peg-IFN have not resulted in high rates of functional cure, further study about combinations of bepirovirsen with other investigational products to increase the possibility of functional cure is expected.