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Tobevibart + elebsiran is an investigational combination therapy for chronic hepatitis delta (CHD) and chronic hepatitis B. Tobevibart is a broadly neutralizing monoclonal antibody targeting the hepatitis B surface antigen; it inhibits the entry of both hepatitis B virus (HBV) and hepatitis delta virus (HDV) into hepatocytes and reduces circulating viral particles. Elebsiran (also known as VIR-2218) is a small interfering RNA (siRNA) designed to degrade HBV RNA transcripts, thereby limiting production of the hepatitis B surface antigen and exerting direct antiviral activity against both HBV and HDV. Both agents are administered subcutaneously. The combination has demonstrated rapid, deep suppression of HDV RNA in clinical trials, with 100% of participants in the combination arm achieving significant virologic response at week 24 in phase 2 studies. The therapy has received FDA Breakthrough Therapy designation and EMA PRIME designation for CHD[1][3][5][6].
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