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Isothiafludine (NZ-4) is a small molecule capsid assembly modulator (CpAM) developed by the Shanghai Institute of Materia Medica, Chinese Academy of Sciences, in collaboration with Ningbo Nuoze Pharmaceutical for the treatment of chronic hepatitis B (CHB). Unlike traditional nucleos(t)ide analogues that target the viral polymerase, isothiafludine acts as a non-nucleoside inhibitor that binds to the Hepatitis B virus core protein (HBcAg). This binding interferes with the protein-protein interactions required for the assembly of the viral nucleocapsid, leading to the formation of empty or aberrant capsids and preventing the encapsidation of pregenomic RNA (pgRNA). By disrupting these critical steps in the viral life cycle, isothiafludine aims to reduce viral replication and potentially contribute to a functional cure for HBV. It has been evaluated in Phase 1 and Phase 2 clinical trials in China.
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