What are the latest developments in the search for a cure for Ebola?

[Ygggdrasil]

TL;DR Summary

Preliminary data from trials of two new treatments for Ebola suggest that they can cure ~90% of infected individuals.

This week, the US National Institutes of Health released an update on a trial in the Democratic Republic of the Congo comparing the effectiveness of two new antibody-based drugs (REGN-EB3 and mAb114) against existing treatments for Ebola (ZMapp and remdesivir). The trial was halted early because the data showed that the new drugs showed they were much more effective than the other treatments, so the NIH will now administer the new treatments to all patients in the study.

Among patients who were brought into treatment centers with low viral loads — which suggested that they had been infected only days before — only 6 percent of those who got Regeneron drug died, and only 11 percent of those who got the Biotherapeutics drug died, Dr. Fauci said.

By contrast, 33 percent of those who received the antiviral drug made by Gilead died, as did 24 percent of those who got ZMapp, an older monoclonal antibody cocktail that was tested briefly during the Ebola outbreak in West Africa in 2014.

The death rate among untreated and unvaccinated patients in this outbreak is thought to be over 70 percent, said Dr. Michael J. Ryan, director of emergency response for the W.H.O.

https://www.nytimes.com/2019/08/12/health/ebola-outbreak-cure.html
Formal analysis and publication of the trial results awaits completion of data collection, which is expected to finish in late Sep/early Oct.

Combined with experimental vaccines, these new treatments can hopefully help contain the current Ebola outbreak and future outbreaks, though quickly administering the drugs to infected individuals remains an issue (especially where there is violence and distrust of governments, as is the case with the currrent outbreak in the DRC).

 

[pinball1970]

Summary: Preliminary data from trials of two new treatments for Ebola suggest that they can cure ~90% of infected individuals.

This week, the US National Institutes of Health released an update on a trial in the Democratic Republic of the Congo comparing the effectiveness of two new antibody-based drugs (REGN-EB3 and mAb114) against existing treatments for Ebola (ZMapp and remdesivir). The trial was halted early because the data showed that the new drugs showed they were much more effective than the other treatments, so the NIH will now administer the new treatments to all patients in the study.https://www.nytimes.com/2019/08/12/health/ebola-outbreak-cure.html
Formal analysis and publication of the trial results awaits completion of data collection, which is expected to finish in late Sep/early Oct.

Combined with experimental vaccines, these new treatments can hopefully help contain the current Ebola outbreak and future outbreaks, though quickly administering the drugs to infected individuals remains an issue (especially where there is violence and distrust of governments, as is the case with the currrent outbreak in the DRC).

The drug is based on monoclonal antibodies according to the link.

Does this mean a major mutation in the virus could affect the treatment?

 

[Ygggdrasil]

The drug is based on monoclonal antibodies according to the link.

Does this mean a major mutation in the virus could affect the treatment?

The drugs are indeed monoclonal antibodies, and like all drugs, could be subject to resistance through mutation of the virus. This is most true of mAB114, which is a single monoclonal antibody (https://www.ncbi.nlm.nih.gov/pubmed/26917593?dopt=Abstract). REGN-EB3 is a cocktail of three different antibodies (https://www.ncbi.nlm.nih.gov/pubmed/29860496) and it would presumably be much more difficult for the virus to acquire multiple mutations simultaneously to gain resistance to all three.

Because the epitopes targeted by the antibodies are known, monitoring the virus through DNA sequencing could likely help diagnose the arrival of resistant stains.

 

[berkeman]

Summary: Preliminary data from trials of two new treatments for Ebola suggest that they can cure ~90% of infected individuals.

The trial was halted early because the data showed that the new drugs showed they were much more effective than the other treatments, so the NIH will now administer the new treatments to all patients in the study.

Yeah, that would suck to be on the wrong end of that double-blind study!

Glad they stopped early and administered the drug to all. What a promising advance!

 

[pinball1970]

Yeah, that would suck to be on the wrong end of that double-blind study!

Glad they stopped early and administered the drug to all. What a promising advance!

Underreported in West and a horrific disease. Not many grade 4 out there, Lassa is one.
Hats off to the guys who try and manage this in the field. Medecins sans frontieres for example.

 

[Ygggdrasil]

Underreported in West and a horrific disease. Not many grade 4 out there, Lassa is one.
Hats off to the guys who try and manage this in the field. Medicins sans frontiers for example.

MSF played a key role in the trial as the trials were carried out in Ebola Treatment centers run by staff from the DRC Institut National de Recherche Biomédicale (INRB); the DRC Ministry of Health; and three medical humanitarian organizations: the Alliance for International Medical Action (ALIMA), the International Medical Corps (IMC), and Médecins Sans Frontières (MSF).

Indeed, the study is a good example of the usefulness of international public-private partnerships as the study is co-sponsored and funded by the DRC's INRB and the National Institute of Allergy and Infectious Diseases (NIAID) of the U.S. National Institutes of Health; carried out by an international research consortium coordinated by the World Health Organization (WHO); and supported by four pharmaceutical companies (MappBio, Gilead, Regeneron, and Ridgeback Biotherapeutics).

Hats off to all entities involved.

 

[Laroxe]

This sounds very impressive but I expect that these drugs like all of the biologics will be horrendously expensive. The trial was supported by the drug companies and others but I wonder if it will be possible to deploy these drugs widely. The current outbreak and the previous one in west Africa have both had thousands of confirmed cases.

 

[Mary Conrads Sanburn]

Wow! It makes me cry. I did find this article ~

At 1-year mark, we mourn the lives lost to Ebola, and call for solidarity
Joint statement by heads of agencies on the Ebola outbreak in the Democratic Republic of the Congo
31 July 2019
Statement

New York, Geneva, Kinshasa, Rome

“Tomorrow, 1 August, marks one year since the Government of the Democratic Republic of the Congo (DRC) declared an outbreak of the Ebola virus disease in North Kivu province of the DRC. Two weeks ago, it was declared a public health emergency of international concern.

“Just yesterday, a new case of the disease was confirmed in Goma, with the patient later dying – the second case to be confirmed this month in the city of around 1 million people. This latest case in such a dense population center underscores the very real risk of further disease transmission, perhaps beyond the country’s borders, and the very urgent need for a strengthened global response and increased donor investment.
“In the last year, there have been more than 2,600 confirmed cases, including more than 1,800 deaths in parts of Ituri and North Kivu provinces. Almost one in three ‘cases’ is a child. Every single ‘case’ is someone who has gone through an unimaginable ordeal. More than 770 have survived.
“The disease is relentless and devastating.

[. . .]

“At this critical juncture, we reaffirm our collective commitment to the people of the DRC; we mourn for those we have lost; and we call for solidarity to end this outbreak.”

Statement from WHO Director-General Dr Tedros Adhanom Ghebreyesus, UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Mark Lowcock, UNICEF Executive Director Henrietta Fore, and World Food Programme Executive Director David Beasley
https://www.who.int/news-room/detai...-mourn-the-lives-lost-and-call-for-solidarity