RegulationFast Track (United States), Orphan Drug (European Union), Breakthrough Therapy (China), PRIME (European Union), Breakthrough Therapy (United States)

Structure/Sequence

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Sequence Code 286629921

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Sequence Code 1191632800

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Clinical Trials associated with Elebsiran

NCT06903338

/ RecruitingPhase 3

A Phase 3 Randomized, Open-Label Study to Evaluate the Efficacy and Safety of Tobevibart + Elebsiran Combination Therapy in Participants With Chronic HDV Infection (ECLIPSE 1)

This is a multicenter, open label, randomized Phase 3 clinical study to evaluate the efficacy and safety of the combination of tobevibart + elebsiran for the treatment of chronic hepatitis delta in comparison to delayed treatment.

Start Date12 Mar 2025

Sponsor / Collaborator

Vir Biotechnology, Inc.

NCT06650852

/ Active, not recruitingPhase 2

A Phase 2 Multicenter, Randomized, Double-Blind Study to Evaluate the Efficacy and Safety of Combination Therapy of BRII-179, BRII-835 and Pegylated Interferon Alpha (PEG-IFNα) in Participants With Chronic Hepatitis B Virus (HBV) Infection (ENHANCE)

This Phase 2, randomized, double-blind study will evaluate the clinical efficacy and safety of the combination therapy of BRII-179, BRII-835, plus PEG-IFNα compared to PEG-IFNα in adult participants with chronic HBV infection without cirrhosis receiving neucloes(t)ide reverse transcriptase inhibitors (NRTIs) as background therapy.

Start Date31 Oct 2024

Sponsor / Collaborator

Brii Biosciences Ltd.

CTR20243850

/ Active, not recruitingPhase 2

一项评价BRII-179、BRII-835和聚乙二醇干扰素α（PEG-IFNα）联合治疗在慢性乙型肝炎病毒（HBV）感染受试者中有效性和安全性的II期、多中心、随机、双盲研究（ENHANCE研究）

[Translation] A Phase II, multicenter, randomized, double-blind study to evaluate the efficacy and safety of BRII-179, BRII-835, and pegylated interferon alpha (PEG-IFNα) in subjects with chronic hepatitis B virus (HBV) infection (ENHANCE study)

本研究旨在评价BRII-179、BRII-835和PEG-IFNα联合治疗与PEG-IFNα治疗相比在接受核苷（酸）类逆转录抑制剂作为背景治疗的无肝硬化的慢性HBV成人感染受试者中的临床有效性和安全性。

[Translation]

This study aims to evaluate the clinical efficacy and safety of BRII-179, BRII-835, and PEG-IFNα combination therapy compared with PEG-IFNα therapy in adult subjects with chronic HBV infection without cirrhosis who are receiving background therapy with nucleos(t)ide reverse transcriptase inhibitors.

Start Date17 Oct 2024

Sponsor / Collaborator

SciVac Ltd.

[+2]

100 Clinical Results associated with Elebsiran

100 Translational Medicine associated with Elebsiran

100 Patents (Medical) associated with Elebsiran

Literatures (Medical) associated with Elebsiran

01 Mar 2025·GASTROENTEROLOGY

The Impact of Hepatitis B Surface Antigen Reduction via Small Interfering RNA Treatment on Natural and Vaccine (BRII-179)-Induced Hepatitis B Vaccine-Specific Humoral and Cellular Immune Responses

Article

Author: Tan, Ying ; Ma, Haiyan ; Lee, Ariel ; Bertoletti, Antonio ; Chen, Jieliang ; Wang, Bing ; Zhu, Chong ; Douglas, Mark W ; Lai-Hung Wong, Grace ; Li, Dong ; Chen, Xiaofei ; Ji, Yun ; Yuen, Man-Fung ; Lv, Jianxiang ; Zhu, Qing ; Le Bert, Nina

BACKGROUND & AIMS:

The impact of hepatitis B surface antigen (HBsAg) reduction from small interfering RNA (siRNA) treatments on hepatitis B virus (HBV)-specific immunity of individuals with chronic hepatitis B (CHB) has not been adequately analyzed in humans. We conducted a phase 2a study treating CHB participants with nine 4-weekly doses of HBV-targeted siRNA elebsiran (BRII-835), either alone (n = 10) or in combination with a virus-like particle-based therapeutic vaccine (BRII-179) containing Pre-S1, Pre-S2, and S antigens, coadministered with (n = 39) or without (n = 41) interferon alfa.

METHODS:

We analyzed longitudinally for 72 weeks virologic, clinical, and immunologic parameters, including HBsAg, alanine aminotransferase, hepatitis B surface antibody (anti-HBs) antibodies, the neutralizing activity of representative sera, and frequency and cytokine secretion ability of T cells specific for Pre-S1, Pre-S2, and S both directly ex vivo and after in vitro expansion.

RESULTS:

Combination therapy with elebsiran and BRII-179 was well tolerated. Although no sustained HBsAg seroclearance or notable difference in mean HBsAg reduction at the group level was observed, we detected marked heterogeneity in immunologic responses among groups. HBsAg reduction mediated by siRNA alone was associated with minimal HBV-specific immune response recovery. In contrast, combination of elebsiran with BRII-179 induced a significant modification of immune responses demonstrated by anti-HBs antibody production and an expansion of interleukin 2-producing cluster of differentiation 4-positive T cells specific for Pre-S1/Pre-S2 antigens only. Importantly, anti-HBs antibodies persisted at ≥100 IU/L in ∼40% of the participants for at least 32 weeks after combined treatment. Moreover, the neutralizing ability of the anti-HBs-positive sera was associated with HBsAg reduction.

CONCLUSIONS:

siRNA-induced HBsAg reduction may contribute to the persistence and efficacy of the humoral arm of HBV-specific adaptive immunity in CHB participants receiving the therapeutic vaccine BRII-179.

CLINICALTRIALS:

gov number: NCT04749368.

01 Dec 2024·Lancet Gastroenterology & Hepatology

VIR-2218 (elebsiran) plus pegylated interferon-alfa-2a in participants with chronic hepatitis B virus infection: a phase 2 study

Article

Author: Lim, Tien-Huey ; Yuen, Man-Fung ; Gane, Edward ; Cloutier, Daniel ; Yoon, Ki Tae ; Gupta, Sneha V ; Arizpe, Andre ; Lim, Young-Suk ; Mao, Shenghua ; Heo, Jeong ; Thanawala, Vaidehi ; Cathcart, Andrea L ; Hwang, Carey ; Tak, Won Young ; Tangkijvanich, Pisit

BACKGROUND:

Chronic hepatitis B virus (HBV) remains a global concern, with current treatments achieving low rates of HBsAg seroclearance. VIR-2218 (elebsiran), a small interfering RNA agent against HBV transcripts, reduces HBsAg concentrations. We aimed to evaluate the safety and antiviral activity of VIR-2218 with and without pegylated interferon-alpha-2a treatment in participants with chronic HBV.

METHODS:

This open-label, phase 2 study was conducted at 23 sites in six countries (New Zealand, Australia, Hong Kong, Thailand, South Korea, and Malaysia). Adults (aged 18-65 years) with chronic HBV infection without cirrhosis and with HBsAg more than 50 IU/mL and HBV DNA less than 90 IU/mL who were on continued nucleoside or nucleotide reverse transcriptase inhibitor (NRTI) therapy for 2 months or longer were eligible. Participants were enrolled into one of six cohorts to receive VIR-2218 200 mg subcutaneously every 4 weeks, with or without 180 μg subcutaneous pegylated interferon-alfa-2a once per week. Cohort 1 received six doses of VIR-2218 (total 20 weeks); cohort 2 received six doses of VIR-2218 starting at day 1, plus 12 doses of pegylated interferon-alfa-2a starting at week 12 (total 24 weeks); cohort 3 received six doses of VIR-2218 and 24 doses of pegylated interferon-alfa-2a (total 24 weeks); cohort 4 received six doses of VIR-2218 and up to 48 doses of pegylated interferon-alfa-2a (total 48 weeks); cohort 5 received up to 13 doses of VIR-2218 and up to 44 doses of pegylated interferon-alfa-2a (total 48 weeks); and cohort 6 received three doses of VIR-2218 and 12 doses of pegylated interferon-alfa-2a (total 12 weeks). The primary endpoints were the incidence of adverse events and clinical assessments (including results of laboratory tests). Secondary endpoints were the mean maximum reduction of serum HBsAg at any timepoint; the proportion of participants with serum HBsAg seroclearance at any timepoint and for more than 6 months after the end of treatment; and the proportion of participants with anti-HBs seroconversion at any timepoint. For patients who were HBeAg-positive, we also assessed the proportion with HBeAg seroclearance or anti-HBe seroconversion at any timepoint. This study is registered with ClinicalTrials.gov, NCT03672188, and is ongoing.

FINDINGS:

Between July 2, 2020, and Nov 2, 2021, 124 individuals were screened for eligibility, 84 of whom were enrolled (15 in cohort 1, 15 in cohort 2, 18 in cohort 3, 18 in cohort 4, 13 in cohort 5, and five in cohort 6). Participants were predominantly HBeAg-negative, Asian, and male (66 [79%] participants were male and 18 [21%] were female). Most treatment emergent adverse events were grades 1-2. Three (20%) participants in cohort 1, four (27%) in cohort 2, eight (44%) in cohort 3, seven (39%) in cohort 4, six (46%) in cohort 5, and two (40%) in cohort 6 reported treatment-emergent adverse events related to VIR-2218. 12 (80%) participants in cohort 2, 12 (67%) in cohort 3, 14 (78%) in cohort 4, 13 (100%) in cohort 5, and three (60%) in cohort 6 reported treatment-emergent adverse events related to pegylated interferon-alfa-2a. Two (13%) participants in cohort 1 had elevations in alanine aminotransferase, compared with 13 (87%) participants in cohort 2, 15 (83%) in cohort 3, 17 (94%) in cohort 4, 11 (85%) in cohort 5, and three (60%) in cohort 6. The mean maximum change from baseline at any timepoint in HBsAg concentration was -2·0 log₁₀ IU/mL (95% CI -2·1 to -1·8) in cohort 1, -2·2 log₁₀ IU/mL (-2·5 to -1·8) in cohort 2, -2·5 log₁₀ IU/mL (-2·8 to -2·1) in cohort 3, -2·4 log₁₀ IU/mL (-3·1 to -1·8) in cohort 4, -3·0 log₁₀ IU/mL (-3·7 to -2·3) in cohort 5, and -1·7 log₁₀ IU/mL (-2·1 to -1·4) in cohort 6. 11 participants (one in cohort 2, one in cohort 3, five in cohort 4, and four in cohort 5) receiving VIR-2218 plus pegylated interferon-alfa-2a had HBsAg seroclearance at any timepoint. Of these, ten (91%; one in cohort 2, five in cohort 4, and four in cohort 5) had anti-HBs seropositivity. Six participants (one in cohort 2, three in cohort 4, and two in cohort 5) had sustained HBsAg seroclearance through to 24 weeks after the end of treatment. No participants receiving VIR-2218 monotherapy (cohort 1) or VIR-2218 plus pegylated interferon-alfa-2a 12-week regimen (cohort 6) had HBsAg seroclearance. 12 (42%) of 26 participants (one of four in cohort 1, two of six in cohort 2, four of seven in cohort 3, four of six in cohort 4, and one of three in cohort 5) who were HBeAg positive at baseline had HBeAg seroclearance or anti-HBe seroconversion.

INTERPRETATION:

The results of this phase 2 study support further development of VIR-2218 as a potential therapy for patients with chronic HBV infection. Additional clinical trials of VIR-2218 with and without pegylated interferon-alfa-2a in combination with an HBsAg-targeting monoclonal antibody are ongoing.

FUNDING:

Vir Biotechnology.

01 Oct 2023·Journal of hepatology

Evaluation of RNAi therapeutics VIR-2218 and ALN-HBV for chronic hepatitis B: Results from randomized clinical trials

Article

Author: Lempp, Florian A ; Huang, Stephen A ; Gane, Ed ; Shen, Ling ; Cloutier, Daniel J ; Taubel, Jorg ; Cathcart, Andrea L ; Jadhav, Vasant ; Anglero-Rodriguez, Yesseinia I ; Kim, Jae B ; Milstein, Stuart ; Kaittanis, Charalambos ; Janas, Maja M ; Lim, Young-Suk ; Bakardjiev, Anna I ; Yuen, Man-Fung ; Pang, Phillip S ; Sepp-Lorenzino, Laura ; Hinkle, Gregory ; Haslett, Patrick ; Hebner, Christy M

BACKGROUND & AIMS:

Current therapy for chronic hepatitis B virus (cHBV) infection involves lifelong treatment. New treatments that enable HBV functional cure would represent a clinically meaningful advance. ALN-HBV and VIR-2218 are investigational RNA interference therapeutics that target all major HBV transcripts.

METHODS:

We report on: i) the safety of single doses of VIR-2218 (modified from ALN-HBV by enhanced stabilization chemistry plus technology to reduce off-target, seed-mediated binding while maintaining on-target antiviral activity) and ALN-HBV in humanized mice; ii) a cross-study comparison of the safety of single doses of VIR-2218 and ALN-HBV in healthy human volunteers (n = 24 and n = 49, respectively); and iii) the antiviral activity of two doses of 20, 50, 100, 200 mg of VIR-2218 (total n = 24) vs. placebo (n = 8), given 4 weeks apart, in participants with cHBV infection.

RESULTS:

In humanized mice, alanine aminotransferase (ALT) levels were markedly lower following administration of VIR-2218 compared with ALN-HBV. In healthy volunteers, post-treatment ALT elevations occurred in 28% of participants receiving ALN-HBV compared with none in those receiving VIR-2218. In participants with cHBV infection, VIR-2218 was associated with dose-dependent reductions in hepatitis B surface antigen (HBsAg). The greatest mean reduction of HBsAg at Week 20 in participants receiving 200 mg was 1.65 log IU/ml. The HBsAg reduction was maintained at 0.87 log IU/ml at Week 48. No participants had serum HBsAg loss or hepatitis B surface antibody seroconversion.

CONCLUSIONS:

VIR-2218 demonstrated an encouraging hepatic safety profile in preclinical and clinical studies as well as dose-dependent HBsAg reductions in patients with cHBV infection. These data support future studies with VIR-2218 as part of combination regimens with a goal of HBV functional cure.

TRIAL REGISTRATION:

ClinicalTrials.gov identifiers: NCT02826018 and NCT03672188.

IMPACT AND IMPLICATIONS:

A significant unmet need exists for therapies for chronic HBV (cHBV) infection that achieve functional cure. We report clinical and non-clinical data on two investigational small-interfering RNAs that target HBx, ALN-HBV and VIR-2218, demonstrating that incorporation of enhanced stabilization chemistry plus technology in VIR-2218 reduces its propensity to cause ALT elevations relative to its parent compound, ALN-HBV. We also show that VIR-2218 reduces hepatitis B surface antigen levels in a dose-dependent manner in participants with cHBV infection. These studies support the continued development of VIR-2218 as part of therapeutic regimens for cHBV infection, with the goal of a functional cure, and are important for HBV researchers and physicians.

103

News (Medical) associated with Elebsiran

30 Mar 2025

·www.prnewswire.com

Brii Bio Unveils New Data from Its Ongoing Phase 2 ENSURE Study at APASL 2025, Showcasing BRII-179's Unique Potential to Prime and Boost Higher HBsAg Loss Through Target Patient Identification

Preliminary data from Cohort 4 of the ENSURE study supports a novel enrichment strategy to utilize BRII-179 to identify patients who are immune responders and have the potential to achieve higher HBsAg loss at EOT 48-week EOT data from Cohort 1-3 of the ENSURE study clearly suggests the added benefits of elebsiran towards achieving a higher rate of HBsAg loss in combination with PEG-IFNα DURHAM, N.C. and BEIJING, China, March 30, 2025 /PRNewswire/ -- Brii Biosciences Limited ("Brii Bio," or the "Company", stock code: 2137.HK), a biotechnology company developing therapies to improve patient health and choice across diseases with high unmet medical needs, announced new data from its ongoing Phase 2 ENSURE study as a late-breaking oral presentation at the 34th Annual Meeting of Asian Pacific Association for the Study of the Liver (APASL 2025) in Beijing, China. ENSURE (NCT05970289) is a multicenter, open-label Phase 2 study. Cohorts 1-3 were designed to evaluate the contribution of elebsiran, an investigational small interfering ribonucleic acid (siRNA), in combination with pegylated interferon alpha (PEG-IFNα) in participants with chronic HBV infection with baseline hepatitis B surface antigen (HBsAg) of 100-3,000 IU/mL. Participants who completed 9 doses of BRII-179, a recombinant protein-based therapeutic vaccine, in combination with elebsiran (BRII-835) in a previous APAC study BRII-179-835-001 (NCT04749368) were enrolled to Cohort 4 of this study and received elebsiran and PEG-IFNα combination treatment. The design of Cohort 4 as part of this study was based on insight from previous studies that a significant proportion of the chronic HBV patients fail to generate a sufficient immune response after receiving multiple doses of BRII-179, and therefore unlikely to have the immune support to achieve sustainable functional cure. Emerging data from Cohort 4 showed that participants who previously had BRII-179 induced anti-HBs response achieved a substantially higher rate of HBsAg seroclearance than those who did not. At Week 24, more than half of the BRII-179 responders (55.6% [10/18]) achieved HBsAg seroclearance, compared to only 10.0% (1/10) in non-responders. These latest data suggest that BRII-179 can serve as a predictive tool for enriching patients more likely to respond to curative therapies. Additional data from Cohorts 1-3 of the ENSURE study showed that higher end of treatment (EOT) HBsAg loss and seroconversion rates in participants receiving elebsiran in combination with PEG-IFNα than those receiving PEG-IFNα alone. "The positive Cohort 4 data from the ENSURE study opens new doors for HBV functional cure," said Dr. Grace Lai-Hung Wong, Professor of Gastroenterology and Hepatology at CUHK Medical Data Analytics Centre (MDAC) and Department of Medicine and Therapeutics in Hong Kong SAR, China. "Previous studies have suggested that BRII-179 may offer a unique opportunity to identify CHB patients who are able to elicit the necessary HBsAg antibody response. I believe these new findings provide clear evidence supporting such value proposition and further substantiate the role of BRII-179 in shaping future combination therapies." "We are encouraged that the Cohort 4 from the ENSURE study continue to support our enrichment strategy in developing a functional cure for chronic HBV in target populations," said David Margolis, MD, Chief Medical Officer of Brii Bio. "The results underscore the potential of BRII-179 in identifying patients who are more likely to respond to regimens aimed at functional cure, thereby enhancing functional cure rates in the target population while reducing exposure to costly therapies for those with a lower probability of cure. We are committed to advancing BRII-179 in combination with various modalities through our ongoing studies and collaborations with strategic partners, aiming to deliver higher functional cure rates to 254 million patients worldwide living with chronic HBV infection." Abstract Number: OP0335 Presentation Title: Responders to Prior BRII-179 Treatment Achieved Faster and Higher Rate of HBsAg Seroclearance Following Treatment of Elebsiran and PEG-IFNα in Participants with Chronic Hepatitis B Virus Infection: Preliminary Data from ENSURE Study Presenter: Grace Lai-Hung Wong, MBChB (CUHK), MD (CUHK), FRCP (Lond, Edin), FHKCP, FHKAM (Medicine), Professor of Gastroenterology and Hepatology at CUHK Medical Data Analytics Centre (MDAC) and Department of Medicine and Therapeutics in Hong Kong SAR, China Among the 28 of the 31 participants enrolled in Cohort 4 with baseline HBsAg ≥ 100 IU/mL being analyzed, 18 participants with peak anti-HBs ≥ 10 IU/L induced by prior BRII-179 treatment were defined as BRII-179 responders and 10 participants with peak anti-HBs < 10 IU/L were defined as non-responders. At Week 24 of treatment with elebsiran + PEG-IFNα, 39.3% (11/28) of the Cohort 4 participants achieved HBsAg seroclearance. The rate of HBsAg seroclearance at Week 24 in the BRII-179 responders was 55.6% (10/18), notably higher compared to the non-responders at 10% (1/10). Responders to prior BRII-179 treatment appeared to achieve a faster HBsAg seroclearance compared to BRII-179 naïve participants receiving elebsiran + PEG-IFNα as previously reported. Elebsiran and PEG-IFNα combination therapy was generally safe and well tolerated in participants with virally suppressed chronic HBV infection. Treatment with elebsiran + PEG-IFNα is ongoing for 48 weeks. Abstract Number: LB0009 Presentation Title: Higher end of treatment (EOT) HBsAg loss and seroconversion rates in participants with chronic HBV infection receiving elebsiran (BRII-835) and pegylated interferon alfa-2a (PEG-IFNα) compared to PEG-IFNα alone: Week 48 results from ongoing ENSURE study Presenter: Jidong Jia, M.D., Ph.D., Professor of Medicine at the Liver Research Centre, Beijing Friendship Hospital, Capital Medical University in Beijing, China The rates of HBsAg seroclearance at EOT in elebsiran 200 mg + PEG-IFNα and elebsiran 100 mg + PEG-IFNα cohorts were 26.3% (5/19) and 33.3% (6/18), respectively, notably higher compared to PEG-IFNα alone cohort (5.6%) in participants with baseline HBsAg levels 100-3,000 IU/mL. Greater HBsAg reductions at EOT were observed in elebsiran + PEG-IFNα combination cohorts (mean [SE]: -2.47 [0.28] or -3.01 [0.28] log10 IU/mL in elebsiran 200 mg or 100 mg, respectively) than in PEG-IFNα cohort (-1.02 [0.30] log10 IU/mL). Elebsiran in combination with PEG-IFNα at both 200 mg and 100 mg doses achieved similar HBsAg reductions and seroclearance rates. Elebsiran and PEG-IFNα combination therapy was generally safe and well tolerated in participants with virally suppressed chronic HBV infection. Post-treatment follow-up is ongoing and will continue for 24 weeks after discontinuation of treatment. As part of Brii Bio's unique approach to developing a functional cure for HBV, the Company and its partners are actively progressing multiple combination studies with our differentiated portfolio, including BRII-179, a recombinant protein-based HBV immunotherapeutic being evaluated in multiple combination studies with elebsiran led by Brii Bio; elebsiran being evaluated in combination with PEG-IFNα in studies led by Brii Bio and tobevibart, an investigational broadly neutralizing monoclonal antibody targeting HBV, being evaluated in multiple Phase 2 and 3 tobevibart and elebsiran combination studies led by Vir Biotechnology. Key data readouts will be shared in the coming months at the scientific conferences throughout 2025. About Hepatitis B Hepatitis B virus (HBV) infection is one of the world's most significant infectious disease threats with more than 254 million people infected globally.[1] Chronic HBV infection is the leading cause of liver disease and an estimated 820,000 people die of complications from chronic HBV infection each year.[1] HBV is of exceptional concern in China, where 87 million people are chronically infected.[2] About BRII-179 BRII-179 is a novel recombinant protein-based HBV immunotherapeutic candidate that expresses the Pre-S1, Pre-S2, and S HBV surface antigens, and is designed to induce enhanced and broad B-cell and T-cell immunity. In November 2023, the Center for Drug Evaluation (the "CDE") of the National Medical Products Administration (the "NMPA") granted BRII-179 Breakthrough Therapy Designation. About Elebsiran (BRII-835, VIR-2218) Elebsiran is an investigational subcutaneously administered HBV-targeting siRNA designed to degrade hepatitis B virus RNA transcripts and limit the production of hepatitis B surface antigen. It has the potential to have direct antiviral activity against HBV and HDV. It is the first siRNA in the clinic to include Enhanced Stabilization Chemistry Plus technology to enhance stability and minimize off-target activity, which potentially can result in an increased therapeutic index. Brii Bio licensed exclusive rights to develop and commercialize elebsiran for the Greater China territory from Vir Biotechnology, Inc. in 2020. About Brii Bio Brii Biosciences Limited ("Brii Bio", stock code: 2137.HK) is a biotechnology company developing therapies to address major public health challenges where patients experience high unmet medical needs, limited choice and significant social stigmas. With a focus on infectious diseases, the Company is advancing a broad pipeline of unique therapeutic candidates with lead programs against hepatitis B virus (HBV) infection. The Company is led by a visionary and experienced leadership team and has operations in key biotech hubs, including Raleigh-Durham, the San Francisco Bay Area, Beijing and Shanghai. For more information, visit . SOURCE Brii Biosciences Limited WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

Phase 2Clinical ResultBreakthrough TherapyLicense out/inVaccine

13 Mar 2025

·pipelinereview.com

Vir Biotechnology Enrolls First Patient in Phase 3 ECLIPSE Registrational Program for Chronic Hepatitis Delta

SAN FRANCISCO, CA, USA I March 13, 2025 I Vir Biotechnology, Inc. (Nasdaq: VIR) today announced the enrollment of the first patient in its Phase 3 ECLIPSE registrational program. The ECLIPSE registrational program is designed to evaluate the efficacy and safety of tobevibart in combination with elebsiran in people living with chronic hepatitis delta (CHD). ECLIPSE 1, the first trial of the program to be initiated, and ECLIPSE 2 are Phase 3 trials designed to provide the registrational data needed for submission to multiple regulatory agencies. ECLIPSE 3, a Phase 2b trial, is designed to provide important supportive data to help enable access and reimbursement strategies in key European markets. “The start of the ECLIPSE program marks a pivotal moment for patients living with hepatitis delta and for Vir Biotechnology. With a proven track record of developing treatments powering the immune system to transform lives this achievement is a testament to our ability to rapidly advance impactful treatments from discovery to patient care,” said Marianne De Backer, M.Sc., Ph.D., MBA, Chief Executive Officer, Vir Biotechnology. “The data from our SOLSTICE Phase 2 trial suggest that tobevibart and elebsiran can rapidly reduce hepatitis delta virus to undetectable levels, potentially driving important benefit for patients,” said Mark Eisner, M.D., M.P.H., Chief Medical Officer, Vir Biotechnology. “We are excited to further evaluate the potential of this combination in our Phase 3 program.” CHD is a debilitating inflammatory liver disease caused by the hepatitis delta virus (HDV). 1 It is the most severe form of chronic viral hepatitis 2 and on average, people living with CHD will progress to cirrhosis and liver failure within 5 years. 3 There is a high unmet medical need for effective treatments, as there are no approved therapies in the U.S., and options are limited in the European Union and globally. The objective of therapy is to eliminate the virus. Tobevibart in combination with elebsiran offers the potential to achieve this by tackling the viral lifecycle through multiple mechanisms. “Chronic hepatitis delta can be a devastating diagnosis, leaving all those impacted in the U.S. facing an uncertain future without approved treatment options,” said Chari A. Cohen, DrPH, M.P.H., President, Hepatitis B Foundation. “It is exciting to see potential new therapies for hepatitis delta, such as the combination of tobevibart and elebsiran, which could offer new hope to a community that has been waiting for efficacious treatment options for far too long.” The significant unmet need in CHD and the potential for tobevibart and elebsiran to provide a much-needed treatment option has been recognized by the U.S. Food and Drug Administration (FDA) with Breakthrough and Fast Track designations, and by the European Medicines Agency (EMA) Priority Medicines (PRIME) and orphan drug designation. About the ECLIPSE Registrational Program ECLIPSE is a Phase 3 registrational program to evaluate the safety and efficacy of tobevibart in combination with elebsiran in patients with chronic hepatitis delta. ECLIPSE includes three randomized, controlled trials designed to evaluate the combination therapy in comparison to deferred treatment or bulevirtide. ECLIPSE 1, the first trial of the program to be initiated, is a Phase 3 trial that will assess the efficacy and safety of tobevibart and elebsiran compared to deferred treatment in regions such as the U.S. where bulevirtide is not available or other regions where its access is limited. ECLIPSE 2 is a Phase 3 trial that will evaluate the efficacy and safety of switching to tobevibart and elebsiran in people with CHD who have not achieved viral suppression with bulevirtide therapy. ECLIPSE 1 and 2 are designed to provide the registrational efficacy and safety data needed for potential submission to global regulatory agencies. ECLIPSE 3 is a Phase 2b head-to-head trial to evaluate tobevibart and elebsiran compared with bulevirtide in bulevirtide-naïve patients, and it is designed to provide important supportive data to help establish access and reimbursement in key markets. ECLIPSE 1 plans to enroll 120 participants in the U.S. or other regions where bulevirtide use is limited. Participants will be randomized 2:1 to receive either tobevibart in combination with elebsiran or deferred treatment. During the deferred treatment period, participants will receive only nucleoside reverse transcriptase inhibitors (NRTIs). After the initial delay period, participants will be switched to the combination therapy of tobevibart and elebsiran. The composite primary endpoint measures HDV RNA at the lower limit of quantification target not detected or HDV RNA TND (defined as HDV RNA < 0 IU/mL) and ALT normalization at Week 48, compared to the deferred treatment group at the end of their deferred treatment period. About Tobevibart and Elebsiran Tobevibart is an investigational broadly neutralizing monoclonal antibody targeting the hepatitis B surface antigen (HBsAg). It is designed to inhibit the entry of hepatitis B and hepatitis delta viruses into hepatocytes and to reduce the level of circulating viral and subviral particles in the blood. Tobevibart was identified using Vir Biotechnology’s proprietary monoclonal antibody discovery platform. The Fc domain has been engineered to increase immune engagement and clearance of HBsAg immune complexes and incorporates Xencor’s Xtend™ technology to extend half-life. Tobevibart is administered subcutaneously, and it is currently in clinical development for the treatment of patients with chronic hepatitis delta and patients with chronic hepatitis B. Elebsiran is an investigational hepatitis B virus-targeting small interfering ribonucleic acid (siRNA) discovered by Alnylam Pharmaceuticals, Inc. It is designed to degrade hepatitis B virus RNA transcripts and limit the production of hepatitis B surface antigen. Current data indicates that it has the potential to have direct antiviral activity against hepatitis B virus and hepatitis delta virus. Elebsiran is administered subcutaneously, and it is currently in clinical development for the treatment of patients with chronic hepatitis delta and patients with chronic hepatitis B. About Vir Biotechnology, Inc. Vir Biotechnology, Inc., is a clinical-stage biopharmaceutical company focused on powering the immune system to transform lives by discovering and developing medicines for serious infectious diseases and cancer. Its clinical-stage portfolio includes infectious disease programs for chronic hepatitis delta and chronic hepatitis B infections and multiple dual-masked T-cell engagers across validated targets in solid tumor indications. Vir Biotechnology also has a preclinical portfolio of programs across a range of infectious diseases and oncologic malignancies. Vir Biotechnology routinely posts information that may be important to investors on its website. References: 1 NIH National Institute of Diabetes and Digestive and Kidney Diseases Hepatitis D – NIDDK (nih.gov) , accessed February 2025 2 WHO Hepatitis Delta Factsheet – Hepatitis D (who.int) , accessed February 2025 3 CDC What is Hepatitis D – FAQ | CDC , accessed February 2025 SOURCE: Vir Biotechnology

Phase 2Orphan DrugFast TrackPhase 3

27 Feb 2025

·www.fiercebiotech.com

Vir, awaiting \'functional cure\' data for hep B combo, won\'t take treatment forward alone

“Future advancement” in CHB “will be contingent on securing a worldwide development and commercialization partner” outside of Greater China, Vir said.\n Vir Biotechnology may be pushing ahead with its combination therapy in hepatitis D, but it\'s pausing further development in hepatitis B while it seeks a suitable partner.Back in November, Vir arrived at a liver disease conference with phase 2 data showing that two combination regimens utilizing its drugs tobevibart and elebsiran were able to reduce hepatitis B surface antigens. With the news, the company planned to continue the trial to the 24-week stage in order to evaluate whether its cocktail therapy could act as a functional cure for chronic hepatitis B (CHB).According to the biotech’s fourth-quarter earnings release, Vir still expects this data in the second quarter of the year. But what happens next is up in the air.The “future advancement” in CHB “will be contingent on securing a worldwide development and commercialization partner” outside of Greater China, Vir said in the release. This is needed to “best enable further development in this area of high unmet need,\" the company explained.Earlier this month, GSK made a similar move, ending work on one potential functional cure for hepatitis B as it prioritized another in the form of bepirovirsen.With future hepatitis B development sidelined for now, Vir will be steaming ahead with plans to launch a phase 3 trial of the tobevibart-elebsiran combo in hepatitis D in the first half of this year. Early efficacy results from a phase 2 trial last summer suggested the treatment may pose a threat to Gilead Sciences\' stuttering attempt to capture the hepatitis D market.Hepatitis D can only infect people if the hepatitis B virus is present. Compared to people with hepatitis B alone, people living with both viruses have a higher risk of irreversible liver damage and life-threatening complications.No hepatitis D treatments are yet approved in the U.S., where Gilead’s bulevirtide was swatted away by the FDA in 2022. Gilead has since submitted a filing intended to fix the manufacturing and delivery concerns raised in the agency’s complete response letter, and bulevirtide is already available in Europe.Vir also has two solid tumor-focused dual-masked T-cell engager programs in phase 1 trials, with a third due to enter the clinic in the first half of the year. “2024 was a year of transformation for Vir Biotechnology as we successfully defined and executed on our renewed strategic direction, focusing our resources on our most promising programs in infectious diseases and oncology,” CEO Marianne De Backer, Ph.D., said in the Feb. 26 release.“As we enter 2025, we are poised for significant advancement with the initiation of our phase 3 registrational program in chronic hepatitis delta and further clinical progression of our dual-masked T-cell engagers in solid tumors,” De Backer added. “Our disciplined capital deployment and strategic approach to partnerships enable us to maximize value creation from our pipeline and deliver transformative therapies to patients.”

$Vir, awaiting \'functional cure\' data for hep B combo, won\'t take treatment forward alone$

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Indication	Highest Phase	Country/Location	Organization	Date
Hepatitis D, Chronic	Phase 3	-	Vir Biotechnology, Inc.	13 Mar 2025
Hepatitis D	Phase 3	United States	Vir Biotechnology, Inc.	12 Mar 2025
Hepatitis D	Phase 3	Canada	Vir Biotechnology, Inc.	12 Mar 2025
Hepatitis B, Chronic	Phase 2	Australia	Vir Biotechnology, Inc.	03 Jul 2020
Hepatitis B, Chronic	Phase 2	Australia	Alnylam Pharmaceuticals, Inc.	03 Jul 2020
Hepatitis B, Chronic	Phase 2	Hong Kong	Vir Biotechnology, Inc.	03 Jul 2020
Hepatitis B, Chronic	Phase 2	Hong Kong	Alnylam Pharmaceuticals, Inc.	03 Jul 2020
Hepatitis B, Chronic	Phase 2	Malaysia	Vir Biotechnology, Inc.	03 Jul 2020
Hepatitis B, Chronic	Phase 2	Malaysia	Alnylam Pharmaceuticals, Inc.	03 Jul 2020
Hepatitis B, Chronic	Phase 2	New Zealand	Vir Biotechnology, Inc.	03 Jul 2020

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT03672188 (Pubmed \| Lancet Gastroenterol Hepatol)	Phase 1/2	Hepatitis B, Chronic	-	VIR-2218 200 mg + Pegylated interferon-alfa-2a	ioyihomqey(gterzvwzcu) = 20% in cohort 1, 27% in cohort 2, 44% in cohort 3, 39% in cohort 4, 46% in cohort 5, 40% in cohort 6 uulnzumooe (diptsvxmbm ) View more	-	01 Dec 2024
NCT05970289 (ENSURE, NEWS) Manual	Phase 2	Hepatitis B	-	ElebsiranElebsiran 200 mg+PEG-IFNα	izxyecvpxv(ixarijqxxg) = cdkiplpghy srdlcznvva (bzyaiminws ) View more	Positive	19 Nov 2024
				Elebsiran 100mgElebsiran 100mg+PEG-IFNα	izxyecvpxv(ixarijqxxg) = ebqmhrwkzg srdlcznvva (bzyaiminws ) View more
NCT04507269 (CTgov)	Phase 2	Hepatitis B, Chronic	21	VIR-2218 (Part 1: VIR-2218 50 mg)	frbsloporn = ccqeugjvlp jtcjniahgg (awiniaiqox, zzmxhpfiua - gbjrwidxex) View more	-	26 Aug 2024
				VIR-2218 (Part 1: VIR-2218 100 mg)	frbsloporn = mvhxzyzbtd jtcjniahgg (awiniaiqox, zsznhaijjv - qiitrckgzs) View more
NCT03672188 \| NCT02826018 (Pubmed \| J Hepatol)	Phase 1/2	Hepatitis B, Chronic	-	VIR-2218	wsiekoatvx(hglhqqcbmj) = vjyikcdcov vfadvfudkw (zclgoogniz )	-	06 Jun 2023
GlobeNewswire Manual	Phase 2	Hepatitis B	-	VIR-2218VIR-2218 (six-dose regimen of VIR-2218)	safabidyqx(lxvlceivio) = all participants achieving a >1 log10 IU/mL reduction during the trial. aounjrfblv (jrronjoevz ) View more	Positive	25 Jun 2022
				VIR-2218VIR-2218 (two-dose regimen of VIR-2218)
EASL2021	Phase 2	Hepatitis B, Chronic	27	VIR-2218 alone	gknyqsagyw(akondzdmie) = Some participants receiving Peg-IFNa and VIR-2218 combination experienced asymptomatic ALT elevations (grade 2 – 3) concurrent with HBsAg decline ( ≥ 1 log 10 IU/ ml). ALT elevations were not associated with functional changes of the liver (bilirubin, PT or INR). No serious AEs have been reported. ajxvxbihhd (wmpnsjqqee )	-	23 Jun 2021
				VIR-2218 + Peg-IFNa
EASL2020	Phase 2	Hepatitis B	-	VIR-2218	hsaodlfpee(jkmzagqgxh) = klfnswnded csymuefare (yjvgrzvzkb ) View more	Positive	27 Aug 2020
				Placebo	hhsnecasvq(noycsgitqw) = iydrazaqyh jaatiboayj (lcsyhddiaj )
EASL2020	Phase 2	Hepatitis B, Chronic	24	VIR-2218 20 mg	bxszfbfevs(wkfvfjbjrv) = No clinically significant ALTelevations were observed fgkkkmwazz (ncwgrpbikq ) View more	-	27 Aug 2020
				VIR-2218 50 mg

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