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Treating hepatitis D with bulevirtide: real-world experience from 114 patients

Background & Aims - Bulevirtide is a first-in-class entry inhibitor of hepatitis B surface antigen. In July 2020, bulevirtide was conditionally approved for the treatment of hepatitis D, the most severe form of viral hepatitis, which frequently causes end-stage liver disease and hepatocellular c...

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Hauptverfasser: Dietz-Fricke, Christopher (VerfasserIn) , Tacke, Frank (VerfasserIn) , Zöllner, Caroline (VerfasserIn) , Demir, Münevver (VerfasserIn) , Schmidt, Hartmut H. (VerfasserIn) , Schramm, Christoph (VerfasserIn) , Willuweit, Katharina (VerfasserIn) , Lange, Christian M. (VerfasserIn) , Weber, Sabine (VerfasserIn) , Denk, Gerald (VerfasserIn) , Berg, Christoph P. (VerfasserIn) , Grottenthaler, Julia M. (VerfasserIn) , Merle, Uta (VerfasserIn) , Olkus, Alexander (VerfasserIn) , Zeuzem, Stefan (VerfasserIn) , Sprinzl, Kathrin (VerfasserIn) , Berg, Thomas (VerfasserIn) , van Bömmel, Florian (VerfasserIn) , Wiegand, Johannes (VerfasserIn) , Herta, Toni (VerfasserIn) , Seufferlein, Thomas (VerfasserIn) , Zizer, Eugen (VerfasserIn) , Dikopoulos, Nektarios (VerfasserIn) , Thimme, Robert (VerfasserIn) , Neumann-Haefelin, Christoph (VerfasserIn) , Galle, Peter R. (VerfasserIn) , Sprinzl, Martin (VerfasserIn) , Lohse, Ansgar W. (VerfasserIn) , Schulze zur Wiesch, Julian (VerfasserIn) , Kempski, Jan (VerfasserIn) , Geier, Andreas (VerfasserIn) , Reiter, Florian P. (VerfasserIn) , Schlevogt, Bernhard (VerfasserIn) , Gödiker, Juliana (VerfasserIn) , Hofmann, Wolf Peter (VerfasserIn) , Buggisch, Peter (VerfasserIn) , Kahlhöfer, Julia (VerfasserIn) , Port, Kerstin (VerfasserIn) , Maasoumy, Benjamin (VerfasserIn) , Cornberg, Markus (VerfasserIn) , Wedemeyer, Heiner (VerfasserIn) , Deterding, Katja (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: April 2023
In: JHEP reports
Year: 2023, Jahrgang: 5, Heft: 4, Pages: 1-9
ISSN:2589-5559
DOI:10.1016/j.jhepr.2023.100686
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jhepr.2023.100686
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S2589555923000174
Volltext
Verfasserangaben:Christopher Dietz-Fricke, Frank Tacke, Caroline Zöllner, Münevver Demir, Hartmut H. Schmidt, Christoph Schramm, Katharina Willuweit, Christian M. Lange, Sabine Weber, Gerald Denk, Christoph P. Berg, Julia M. Grottenthaler, Uta Merle, Alexander Olkus, Stefan Zeuzem, Kathrin Sprinzl, Thomas Berg, Florian van Bömmel, Johannes Wiegand, Toni Herta, Thomas Seufferlein, Eugen Zizer, Nektarios Dikopoulos, Robert Thimme, Christoph Neumann-Haefelin, Peter R. Galle, Martin Sprinzl, Ansgar W. Lohse, Julian Schulze zur Wiesch, Jan Kempski, Andreas Geier, Florian P. Reiter, Bernhard Schlevogt, Juliana Gödiker, Wolf Peter Hofmann, Peter Buggisch, Julia Kahlhöfer, Kerstin Port, Benjamin Maasoumy, Markus Cornberg, Heiner Wedemeyer, Katja Deterding
Beschreibung
Zusammenfassung:Background & Aims - Bulevirtide is a first-in-class entry inhibitor of hepatitis B surface antigen. In July 2020, bulevirtide was conditionally approved for the treatment of hepatitis D, the most severe form of viral hepatitis, which frequently causes end-stage liver disease and hepatocellular carcinoma. Herein, we report the first data from a large multicenter real-world cohort of patients with hepatitis D treated with bulevirtide at a daily dose of 2 mg without additional interferon. - Methods - In a joint effort with 16 hepatological centers, we collected anonymized retrospective data from patients treated with bulevirtide for chronic hepatitis D. - Results - Our analysis is based on data from 114 patients, including 59 (52%) with cirrhosis, receiving a total of 4,289 weeks of bulevirtide treatment. A virologic response defined as an HDV RNA decline of at least 2 log or undetectable HDV RNA was observed in 87/114 (76%) cases with a mean time to virologic response of 23 weeks. In 11 cases, a virologic breakthrough (>1 log-increase in HDV RNA after virologic response) was observed. After 24 weeks of treatment, 19/33 patients (58%) had a virologic response, while three patients (9%) did not achieve a 1 log HDV RNA decline. No patient lost hepatitis B surface antigen. Alanine aminotransferase levels improved even in patients not achieving a virologic response, including five patients who had decompensated cirrhosis at the start of treatment. Treatment was well tolerated and there were no reports of drug-related serious adverse events. - Conclusions - In conclusion, we confirm the safety and efficacy of bulevirtide monotherapy in a large real-world cohort of patients with hepatitis D treated in Germany. Future studies need to explore the long-term benefits and optimal duration of bulevirtide treatment. - Impact and implications - Clinical trials proved the efficacy of bulevirtide for chronic hepatitis D and led to conditional approval by the European Medical Agency. Now it is of great interest to investigate the effects of bulevirtide treatment in a real-world setting. In this work, we included data from 114 patients with chronic hepatitis D who were treated with bulevirtide at 16 German centers. A virologic response was seen in 87/114 cases. After 24 weeks of treatment, only a small proportion of patients did not respond to treatment. At the same time, signs of liver inflammation improved. This observation was independent from changes in hepatitis D viral load. The treatment was generally well tolerated. In the future, it will be of interest to investigate the long-term effects of this new treatment.
Beschreibung:Online veröffentlicht: 15. März 2023
Gesehen am 24.08.2023
Beschreibung:Online Resource
ISSN:2589-5559
DOI:10.1016/j.jhepr.2023.100686

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