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Pibothiadine (HEC121120) is an orally bioavailable small-molecule capsid assembly modulator (CAM) developed by Sunshine Lake Pharma for the treatment of chronic hepatitis B virus (HBV) infection. It belongs to the class of core protein allosteric modulators (CpAMs), which function by binding to the HBV core protein (HBcAg). This binding disrupts the normal assembly of the viral nucleocapsid, leading to the formation of empty or aberrant capsids and preventing the encapsidation of viral pregenomic RNA (pgRNA). By interfering with these critical steps in the viral lifecycle, pibothiadine inhibits viral replication and reduces the production of infectious virions. It is currently being investigated in Phase 1 and Phase 2 clinical trials, often in combination with nucleos(t)ide analogs like entecavir, to evaluate its safety, pharmacokinetics, and antiviral efficacy in patients with chronic hepatitis B.
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