HBV functional cure likely to be triple combo, but no clear backbone; capsid target too crowded with other approaches showing potential, experts say

26 Apr 2018

A hepatitis B virus (HBV) functional cure will likely be a triple therapy combination for most patients, but it is unclear which of the current investigated therapies are likely to have a pivotal backbone role, experts said.

Although capsid inhibitors/modulators can stop HBV inhibition, there are too many in development, and clinical data is too early to definitively name a frontrunner, experts agreed. Capsid inhibitor/modulators currently under investigation include Assembly Biosciences’(NASDAQ:ASMB) Phase I/II ABI-H0731, Johnson & Johnson’s (NYSE:JNJ) Phase II JNJ-379 (formerly JNJ-56136379) and Phase I NVR3-778, Arbutus Biopharma’s (NASDAQ:ABUS) Phase I AB-423 and preclinical AB-506 and Roche’s (VTX:ROG) Phase I RG7907.

Meanwhile, Spring Bank Pharmaceuticals’ (NASDAQ:SBPH) Phase II inarigivir (formerly SB9200) immunomodulator shows early promise as a pegylated interferon alternative without the side-effect burden. A potential HBV therapy wildcard is Montreal, Canada-based Replicor’s REP2139, which has a unique mechanism trapping surface antigen (HBsAg) inside the cell with significant early data in reducing HBsAg, but mechanism gaps fuel expert doubt on potential side effects.

Asia claims the majority of the HBV market (USD 500m in 2017), followed by the EU (USD 300m) and US (USD 200m).

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