ClinicalTrials.gg
Active, not recruitingNCT05461170Updated Jun 26, 2026

SOLSTICE: Combination Therapy for the Treatment of Chronic Hepatitis D Infection.

A Phase 2 interventional study of VIR-2218 and VIR-3434 in Hepatitis D, Chronic, sponsored by Vir Biotechnology, Inc.. Active, not recruiting at 20 sites in 9 countries. Open to participants aged 18 Years to 69 Years. Per ClinicalTrials.gov, last updated 2026-06-26.

Sponsored by Vir Biotechnology, Inc. · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
95
Allocation
Randomized
Ages
18 Years to 69 Years
Sex
All
01

Study summary

This is a phase 2 trial in which participants with chronic hepatitis D virus (HDV) infection will receive VIR-2218 and/or VIR-3434 and be assessed for safety, tolerability, and efficacy

Read the detailed description

Participants may be enrolled into Cohort 1 (1a and 1b) or Cohort 2 (2a, 2b1 or 2b2, 2c), 3, 4, and 5. All participants still receiving VIR-2218 or VIR-3434 monotherapy at the time of implementation of Protocol Amendment 4 will switch to combination therapy at Week 132 (Cohort 2a, 2b1/2b2) or Week 112 (Cohort 3).

02

Conditions studied

  • Hepatitis D, Chronic

Keywords

  • HDV
  • Hepatitis D Virus
  • Hepatitis
  • Chronic Hepatitis D Virus
  • Hepatitis Delta Virus
03

In context

Hepatitis D, Chronic

43 studies on the registry are indexed under Hepatitis D, Chronic; 9 are open to participants now.

This study's enrollment of 95 is above the median of 46 across 30 interventional studies indexed under Hepatitis D, Chronic.

Browse Hepatitis D, Chronic studies →

Lead sponsor

Vir Biotechnology, Inc. is the lead sponsor of 22 studies on the registry; 2 are open to participants now.

Of its 15 completed or terminated interventional studies of FDA-regulated products, 11 (73%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 69 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male or female ages 18 to \< 70 years at screening
  • Chronic HDV infection for >/= 6 months
  • On NRTI therapy for at least 12 weeks prior to day 1
  • > and \< 5x ULN
  • Non-cirrhotic and CPT-A cirrhotic

Exclusion criteria

Exclusion Criteria:

  • Any chronic or acute medical or psychiatric condition that makes the participant unsuitable for participation.
  • History of significant liver disease from non- or non-HDV etiology
  • History of allergic reactions, , or intolerance to study drug, its metabolites, or .
  • History of anaphylaxis
  • History of immune complex disease
  • History of disorder
  • History or evidence of alcohol or drug abuse
  • Prior or concomitant therapy with an immunomodulatory agent, IFN-alpha, cytotoxic or chemotherapeutic agent, or chronic .
  • Anti-HBs >10 mIU/mL at screening
Terms in these criteria, in plain language(8)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
95 participants (actual)

Study arms

  • Experimental
    Cohort 1a (VIR-2218)

    Participants will receive multiple doses of VIR-2218 for up to 96 weeks total.

    Drug: VIR-2218

  • Experimental
    Cohort 1b (VIR-3434)

    Participants will receive multiple doses of VIR-3434 for up to 96 weeks total.

    Drug: VIR-3434

  • Experimental
    Cohort 2a (VIR-2218)

    Participants will receive multiple doses of VIR-2218 for up to 132 weeks, then assign to Cohort 2c.

    Drug: VIR-2218

  • Experimental
    Cohort 2b1 (VIR-3434)

    Participants will receive multiple doses of VIR-3434 for up to 132 weeks, then assign to Cohort 2c.

    Drug: VIR-3434

  • Experimental
    Cohort 2b2 (VIR-3434)

    Participants will receive multiple doses of VIR-3434 for up to 132 weeks, then assign to Cohort 2c.

    Drug: VIR-3434

  • Experimental
    Cohort 2c (VIR-2218 + VIR-3434)

    Participants will receive multiple doses of VIR-2218 + VIR-3434 for up to 336 weeks.

    Drug: VIR-2218 · Drug: VIR-3434

  • Experimental
    Cohort 3 (VIR-3434)

    Participants will receive multiple doses of VIR-3434 for up to 112 weeks, then assign to Cohort 2c.

    Drug: VIR-3434

  • Placebo comparator
    Cohort 4 (NRTI)

    Participants will receive NRTI for 12 weeks, then assign to Cohort 2c or Cohort 3.

    Drug: NRTI

  • Experimental
    Cohort 5 (VIR-2218)

    Participants will receive multiple doses of VIR-2218 for 12 weeks, then assign to Cohort 2c.

    Drug: VIR-2218

Interventions

  • VIR-2218 given by subcutaneous injection

    Also known as: Elebsiran

  • VIR-3434 given by subcutaneous injection

    Also known as: Tobevibart

  • DrugNRTI

    NRTI given orally.

06

What researchers measure

Primary outcomes

  1. Proportion of participants with undetectable HDV RNA (< limit of detection [LOD]) or ≥ 2 log10 decrease in HDV RNA from baseline and alanine aminotransferase (ALT) normalization (ALT < upper limit of normal [ULN]) at Week 24

    Time frame: Up to 24 Weeks

  2. Treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs)

    Time frame: Up to 360 Weeks

Secondary outcomes

  1. Proportion of participants with undetectable HDV RNA (less than LOD) or greater than/equal to 2 log10 decrease in HDV RNA from baseline and ALT normalization at Week 12, Week 48, Week 72, Week 96, Week 144, Week 192, Week 240, Week 288, and Week 336.

    Time frame: Up to 336 Weeks

  2. Proportion of participants with undetectable HDV RNA (less than LOD) or greater than/equal to 2 log10 decrease in HDV RNA from baseline at Week 12, Week 24, Week 48, Week 72, Week 96, Week 144, Week 192, Week 240, Week 288, and Week 336.

    Time frame: Up to 336 Weeks

  3. Proportion of participants with undetectable HDV RNA (less than LOD) at Week 12, Week 24, Week 48, Week 72, Week 96, Week 144, Week 192, Week 240, Week 288, and Week 336.

    Time frame: Up to 336 Weeks

  4. Proportion of participants with HDV RNA < lower limit of quantitation (LLOQ) at Week 12, Week 24, Week 48, Week 72, Week 96, Week 144, Week 192, Week 240, Week 288, and Week 336.

    Time frame: Up to 336 Weeks

  5. Change from baseline in HDV RNA at Week 12, Week 24, Week 48, Week 72, Week 96, Week 144, Week 192, Week 240, Week 288, and Week 336.

    Time frame: Up to 336 Weeks

  6. Proportion of participants with ALT normalization at Week 12, Week 24, Week 48, Week 72, Week 96, Week 144, Week 192, Week 240, Week 288, and Week 336.

    Time frame: Up to 336 Weeks

  7. Incidence of anti-drug antibodies (ADA) and titers of ADA to VIR-3434 at specified study visits up to Week 336 (for cohorts with VIR3434)

    Time frame: Up to 336 Weeks

  8. Change from baseline in liver fibrosis at Week 48, Week 96, Week 144, Week 192, Week 240, Week 288, and Week 336.

    Liver Fibrosis will be measured by conventional Transient Elastography imaging technique reported in kPa.

    Time frame: Up to 336 Weeks.

  9. Change from baseline in Model for End Stage Liver Disease (MELD) score at Week 12, Week 24, Week 36, Week 48, Week 60, Week 72, Week 84, Week 96, Week 144, Week 192, Week 240, Week 288, and Week 336.

    MELD score will be calculated using serum bilirubin, serum creatinine, and International Normalized Ratio.

    Time frame: Up to 336 Weeks

  10. Change from baseline in Child-Pugh-Turcotte (CPT) score at Week 24, Week 48, Week 72, Week 96, Week 144, Week 192, Week 240, Week 288, and Week 336.

    Time frame: Up to 336 Weeks

07

Study locations

20 sites
  • Investigative Site
    Sofia, 1407, Bulgaria
  • Investigative Site
    Sofia, 1431, Bulgaria
  • Investigative Site
    Stara Zagora, 6003, Bulgaria
  • Investigative Site
    Clichy, 92110, France
  • Investigative Site
    Pessac, 33600, France
  • Investigative Site
    Rennes, 35000, France
  • Investigative Site
    Toulouse, 31000, France
  • Investigative Site
    Frankfurt, 60596, Germany
  • Investigative Site
    Hanover, 30625, Germany
  • Investigative Site
    Tübingen, 72076, Germany
  • Investigative Site
    Milan, 20122, Italy
  • Investigative Site
    Pisa, 56124, Italy
  • Investigative Site
    Chisinau, MD-2025, Moldova
  • Investigative Site
    Rotterdam, 3015 GD, Netherlands
  • Investigative Site
    Auckland, 1010, New Zealand
  • Investigative Site
    Bucharest, 021105, Romania
  • Investigative Site
    Birmingham, B15 2TT, United Kingdom
  • Investigative Site
    London, E1 1RF, United Kingdom
  • Investigative Site
    London, SE5 9RS, United Kingdom
  • Investigative Site
    Manchester, M8 5RB, United Kingdom
08

References and documents

Publications

  • Noack J, Anglero-Rodriguez Y, Gall J, Zhou J, LeBlanc S, Liebow A, Bakardjiev A, Hebner CM, Purcell LA, Jadhav V, Corti D, Lempp FA. Combination therapy with tobevibart and elebsiran potently reduces hepatitis B virus surface antigen levels in preclinical in vivo models. Antimicrob Agents Chemother. 2026 Mar 4;70(3):e0112725. doi: 10.1128/aac.01127-25. Epub 2026 Jan 26. PubMed 41586499 ↗
  • Asselah T, Chattergoon MA, Jucov A, Streinu-Cercel A, Lampertico P, Wedemeyer H, Kennedy PT, Gane EJ, Bullard BL, Chow S, Santos D, Camus G, Lu Y, Pilowa C, Hwang C, Correll T, Agarwal K; SOLSTICE Trial Investigators. A Phase 2 Trial of Tobevibart plus Elebsiran in Hepatitis D. N Engl J Med. 2026 Jan 22;394(4):343-353. doi: 10.1056/NEJMoa2508827. Epub 2025 Nov 9. PubMed 41211943 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Sep 2022 (actual). Primary completion is estimated for Nov 2031, 110 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 1, 2022
First posted
Jul 18, 2022
StartActual
Sep 17, 2022
Primary completionEst.
Nov 2031
CompletionEst.
May 2032
Last update
Jun 26, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 26, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05461170
Responsible party
Sponsor
First posted
Jul 18, 2022
Start date
Sep 17, 2022
Primary completion
Nov 2031 (estimated)
Completion
May 2032 (estimated)
Last update
Jun 26, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Studies of the drugs tested here: Elebsiran · Tobevibart

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