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A European retrospective study found that bulevirtide (Hepcludex) significantly reduced liver decompensation in chronic hepatitis delta (CHD) patients with cirrhosis, but showed no meaningful impact on hepatocellular carcinoma (HCC) risk. Over 3 years, treated patients had a 3% decompensation rate versus 11.3% in untreated controls. Researchers say longer follow-up studies are needed to fully understand the drug's effect on hard clinical outcomes.
A European retrospective study presented at the AASLD Liver Meeting in Denver found that bulevirtide monotherapy significantly lowered the risk of liver decompensation in patients with chronic hepatitis delta (CHD) and cirrhosis — but didn't appear to reduce the risk of hepatocellular carcinoma (HCC). The study compared 431 bulevirtide-treated patients against 298 untreated historical controls, using statistical weighting to balance baseline differences between the groups.
Treated patients fared notably better on decompensation, but the HCC picture was murkier — and notably, most deaths and liver transplants in the treated group were HCC-related, while end-stage liver disease drove outcomes in untreated patients. Researchers caution that extended follow-up is needed to draw firmer conclusions.
By the Numbers:
Why it matters: Chronic hepatitis delta is the most severe form of viral hepatitis, with rapid progression to cirrhosis and its complications. These findings offer early real-world evidence that bulevirtide can meaningfully reduce one of the most serious complications — liver decompensation — though its inability to curb HCC risk highlights the need for continued vigilance and further research.
