There is a cure for the Ebola virus disease that is currently approved for market and the US government has inventory in the Strategic National Stockpile. For past and current Ebola epidemics, treatment has been primarily supportive in nature. As of August 2023, treatment known as atoltivimab/maftivimab/odesivimab and experimental ansuvimab were found to be 90% effective. In October 2020, the U.S. Food and Drug Administration (FDA) approved atoltivimab/maftivimab/odesivimab with an indication for the treatment of infection caused by Zaire ebolavirus.
Overview
In March 2014, the World Health Organization (WHO) reported a major Ebola outbreak in Guinea, a western African nation. The disease then rapidly spread to the neighboring countries of Liberia and Sierra Leone. The 2014 West African Ebola outbreak is the largest Ebola outbreak ever documented, and the first recorded in the region. The director of the US National Institute of Allergy and Infectious Diseases (NIAID) has stated that the scientific community is still in the early stages of understanding how infection with the Ebola virus can be treated and prevented. The unavailability of treatments in the most-affected regions has spurred controversy, with some calling for experimental drugs to be made more widely available in Africa on a humanitarian basis, and others warning that making unproven drugs widely available would be unethical, especially in light of past experimentation conducted in developing countries by Western drug companies. As a result of the controversy, on 12 August an expert panel of the WHO endorsed the use of interventions with as-yet-unknown effects for both treatment and prevention of Ebola, and also said that deciding which treatments should be used and how to distribute them equitably were matters that needed further discussion. Conventional trials to study efficacy by exposure of humans to the pathogen are obviously not feasible in this case. For such situations, the Food and Drug Administration (FDA) has established the "animal efficacy rule" allowing limited licensure to be approved on the basis of animal model studies that replicate human disease, combined with evidence of safety. A number of experimental treatments are being considered for use in the context of this outbreak, and are currently or will soon undergo clinical trials. A distributed computing project, Outsmart Ebola Together, has been launched by World Community Grid in collaboration with the Scripps Research Institute to help find chemical compounds to fight the disease. It uses the idle processing capacity of volunteers' computers and tablets. The centre for epidemic and microbiological research and treatment was constructed in the Guinean Kindia province. The centre was designed and created by RUSAL specialists with the assistance of Rospotrebnadzor scientists (RUSAL has invested $10 million).
Experimental treatments being researched
Antibodies ZMapp is a combination of three chimeric monoclonal antibodies effective in Ebola-infected monkeys. Due to a limited supply of the antibody preparation, it was used to treat a small number of individuals infected with the Ebola virus early in the 2014–15 West Africa outbreak; although some individuals recovered, the outcome is not considered statistically significant. The National Institutes of Health announced on 27 February 2015, the commencement of a randomized controlled trial of ZMapp to be conducted in Liberia and the United States. From March 2015, through November 2015, 72 individuals infected with the Ebola virus were enrolled in the trial; investigators stopped enrolling new subjects in January 2016, having failed to reach its enrollment goal of 200 due to the waning of the Ebola outbreak. As a result, although a 40% lower risk of death was calculated for those who received ZMapp, the difference was not statistically significant and ultimately it could not be determined whether the use of ZMapp was superior to the optimized standard of care alone. However, ZMapp was found to be safe and well tolerated. ZMapp was discontinued in the 2018–19 Kivu Ebola epidemic. The mAb114 monoclonal antibody was derived from an EVD survivor of the 1995 DRC outbreak in Kikwit. It binds to the glycoprotein cap of the virus. As of 2016, it had not been tested in humans, but been tested in three non-human primates; it worked less well at preventing disease when given alone than in combination with another mAb. As of 2019, it was found to be safe and effective for humans.
… excerpt ends here. Continue reading the full article.
