New pill combo aims to tame hepatitis d in small trial
NCT ID NCT05229991
First seen Jun 24, 2026 · Last updated Jun 27, 2026 · Updated 1 time
Summary
This completed Phase 3 trial tested a once-daily combination of two drugs, lonafarnib and ritonavir, in 10 adults with chronic hepatitis D. The goal was to see if the regimen is safe and can lower the amount of virus in the blood over 48 weeks of treatment and 24 weeks of follow-up. Because the study is very small, the results are preliminary and need confirmation in larger trials.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- lonafarnib and ritonavir
- What this could lead to
- If it works, this could offer a simpler once-daily pill regimen to control hepatitis D virus levels in patients with chronic infection.
- What could go wrong
- This is a very small, early-phase trial with only 10 participants, so results may not apply broadly. The drug combination may not effectively lower the virus or could cause side effects.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 3
Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.
- Participants
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10 people
The number who actually took part.
- Started
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May 2021
- Finished
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Feb 2025
- Lead sponsor
-
Other sponsor
The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 years and older
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: 1. Chronic HDV infection, with compensated liver disease, documented by a positive HDV antibody (Ab) test and HDV RNA by quantitative polymerase chain reaction (qPCR) assay, prior to initiation of trial treatment. 2. Demonstrable suppression of HBV DNA (\< 100 IU/mL) following anti-HBV nucleos(t)ide treatment prior to initiating trial therapy. 3. Willing and able to comply with trial procedures and provide written informed consent. 4. ALT \> ULN documented on at least one occasion during the 12 months preceding enrollment to the trial. 5. Male and female participants who are 18 years of age or above. 6. ECGs demonstrating no acute ischemia or clinically significant (CS) abnormality and a corrected QT interval by Fridericia correction formula (QTcF) \< 450 ms in males and \<470 ms in females. 7. Sexually active female patients of childbearing potential and sexually active male patients with partners of childbearing potential must agree to use adequate methods of contraception during the trial. Females of childbearing potential are all those except women who are surgically sterile, who have medically documented ovarian failure, or who are at least 1 year postmenopausal. For female patients: * Progestin-based hormonal contraception (implant, injection, oral) associated with inhibition of ovulation for ≥ 3 months before screening. Use of a progestin-based implant or injection method requires the additional use of a barrier method (use of condom \[male partner\] or diaphragm with spermicide or cervical cap with spermicide) from screening. Use of a progestin-only, oral method requires the additional use of double barrier methods (use of condom \[male partner\] with either diaphragm with spermicide or cervical cap with spermicide) from screening, or * Intrauterine device (IUD) or intrauterine system (IUS) in place ≥ 3 months before screening AND a barrier method (use of condom \[male partner\] or diaphragm with spermicide or cervical cap with spermicide) from screening, or * Surgical sterilization of the partner (vasectomy ≥ 1 month before screening) AND a barrier method (use of condom \[male partner\] or diaphragm with spermicide or cervical cap with spermicide) from screening, or * Double-barrier methods (use of condom \[male partner\] with either diaphragm with spermicide or cervical cap with spermicide) from screening. For male patients: * Surgical sterilization (vasectomy ≥ 1 month before screening) AND a barrier method (use of condom or diaphragm with spermicide or cervical cap with spermicide) from screening, or * Consistently and correctly use a condom from screening AND female partner must agree to use a hormonal contraceptive, a nonhormonal non-barrier method (eg, copper IUD), or a nonhormonal barrier method (eg, diaphragm with spermicide or cervical cap with spermicide). Exclusion Criteria: 1. Participation in a clinical trial with, or use of, any investigational agent within 30 days or 5 half-lives, whichever is longer, before starting LNF treatment. 2. Female patients who are pregnant or breastfeeding. Female patients must have a negative serum test at screening and a negative urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin \[hCG\] at baseline, within 24 hours prior to the start of any investigational agent). Male patients with female sexual partners who are pregnant. 3. Current or previous history of decompensated liver disease (e.g. variceal bleeding, ascites, hepatic encephalopathy, hepatorenal syndrome). 4. Platelet count \< 70,000 cells/mm3; white blood cell (WBC) \< 3,000 cells / mm3 5. Creatinine clearance (\< 30 mL/min by Cockroft-Gault). 6. Co-infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV). Patients with a positive HCV Ab at baseline are allowed if they have completed a curative antiviral regimen and have documented undetectable HCV RNA 12 weeks or more following last dose of anti-HCV medications. 7. Abnormal thyroid-stimulating hormone (TSH) or free thyroxine (fT4) levels. Patients with well-controlled thyroid function or TFTs that are not clinically significant may be enrolled. 8. Evidence of another form of viral hepatitis or another form of liver disease (eg, autoimmune liver disease, primary biliary cirrhosis, primary sclerosing cholangitis, Wilson's disease, alcoholic liver disease, nonalcoholic steatohepatitis, hemochromatosis, alpha 1 anti-trypsin deficiency). 9. History of hepatocellular carcinoma. 10. Retinal disorder or clinically relevant ophthalmic disorder 11. Any malignancy within 5 preceding years. Exceptions are malignancies surgically excised with curative intent and/or evidence of being disease free for at least 5 years (eg, breast ductal carcinoma in situ \[DCIS\] or squamous/basal cell skin cancer treated with curative intent), or successfully treated in-situ carcinoma of the cervix 12. Other significant medical condition that may require intervention during the trial. 13. Any condition that may impact proper absorption (eg, short bowel syndrome, inflammatory bowel disease, atrophic gastritis, partial gastrectomy) should be discussed with the Medical Monitor. 14. Consumption of grapefruit, Seville oranges, or product that contains grapefruit or Seville oranges. 15. Use of heparin or warfarin during the trial. 16. Long-term treatment (\> 2 weeks) before or during the trial with agents that have a high risk for nephrotoxicity or hepatotoxicity. 1. Concomitant use (within 2 weeks of Day 1 and throughout trial conduct) of any medications (prescription, OTC, herbal products) or foods as follows: 2. Known potent inhibitors of CYP3A, including statins (with the exception of pravastatin and fluvastatin); 3. Known potent inducers of CYP3A or CYP3A sensitive substrates; 4. Known CYP2C19 and P-gp sensitive substrates with a narrow therapeutic index - refer to the Concomitant Medication Manual for additional instructions; 5. Known sensitive substrates of OCT1 with a narrow therapeutic index; and 6. Drugs known to prolong the PR or QT interval unless otherwise described in this protocol. 17. Concomitant use of medications contraindicated in the prescribing information for RTV.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey
Istanbul, Turkey (Türkiye)
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New Zealand Liver Transplant Unit, Auckland City Hospital
Auckland, New Zealand
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Soroka UMC
Beersheba, Israel
More trials for these conditions
Other studies related to the condition(s) this trial covers.
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- New antibody could tame dual hepatitis b and d infection
- Hope for hepatitis delta patients: study seeks to end lifelong treatment
- New hope for hepatitis d: experimental drug enters final testing phase
- New drug combo aims to tame rare liver virus