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bulevirtide + brelovitug is a combination therapy under investigation for the treatment of chronic hepatitis delta virus (HDV) infection. It consists of bulevirtide, a first-in-class entry inhibitor, and brelovitug (BJT-778), a fully human IgG1 monoclonal antibody. Bulevirtide is a synthetic lipopeptide that mimics the pre-S1 domain of the hepatitis B virus (HBV) large surface protein, binding to and blocking the sodium taurocholate cotransporting polypeptide (NTCP) receptor on hepatocytes, which is essential for HBV and HDV entry. Brelovitug targets the hepatitis B surface antigen (HBsAg), neutralizing circulating virions and promoting the clearance of HBsAg-containing particles. The combination is being developed by Mirum Pharmaceuticals (following its acquisition of Bluejay Therapeutics) and is currently being evaluated in the Phase 3 AZURE-2 clinical trial to determine if the dual mechanism of entry inhibition and antigen clearance provides superior efficacy over bulevirtide monotherapy.
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