HERACLIS_BLV_D: Adherence to Real-Life Therapy With Bulevirtide in Chronic Hepatitis D

Area of Science:

• Hepatology
• Virology
• Pharmacology

Background:

• Bulevirtide (BLV) is a new first-line treatment for chronic hepatitis D (CHD).
• Long-term real-world adherence data for BLV are limited.
• Understanding adherence is crucial for optimizing treatment outcomes.

Purpose of the Study:

• To assess adherence rates during BLV therapy in routine clinical practice.
• To evaluate the impact of adherence on treatment response in CHD patients.
• To identify factors influencing BLV treatment discontinuation.

Main Methods:

• The HERACLIS_BLV_D study (NCT05928000) tracked adult CHD patients starting daily BLV 2 mg.
• Adherence was monitored via the national prescription system.
• Virological response (VR) and biochemical response (BR) were key outcome measures.

Main Results:

• Seventy-six patients were included, with 17% discontinuing BLV (none due to adverse events) over the follow-up period.
• Mean adherence was high (98% in year 1, 93% in year 2, 91% in year 3).
• Poor adherence (<90%) was associated with significantly lower virological response rates.

Conclusions:

• Annual BLV discontinuation rates in clinical practice are below 10%.
• While adherence remains high, it gradually declines after the first year.
• Strategies to support long-term treatment retention are essential to maximize BLV efficacy in CHD.