Scientists said that Ebola can no longer be labelled an incurable disease after success with experimental drug trials in the Democratic Republic of the Congo (DRC) show great success which is good news after struggling with a year-long outbreak of the disease; it is the second biggest ever with 2,800 cases.
On Monday, the World Health Organization (WHO) and the US National Institute of Allergy and Infectious Diseases (US NIAID), a co-sponsor of the trial, said the two monoclonal antibody drugs have had substantially more effect than the drug Zmapp, which was used during the massive Ebola epidemic in Sierra Leone, Liberia and Guinea, and the drug Remdesivir.
According to the WHO, the disease is spread through blood or body fluids, or objects which have been contaminated with body fluids from a sick person. It is thought fruit bats of the Pteropodidae family are natural Ebola virus hosts and that the virus was introduced into the human population through close contact with the bodily fluids of infected animals.
The 2014–2016 outbreak in West Africa was the largest since the virus was first discovered in 1976. The second largest outbreak in history occurred in June in the DRC and Uganda, killing 1,400 people.
According to The Guardian, Anthony Fauci, the director of the US NIAID, explained the overall mortality of those who were given ZMapp in the trial was 49 per cent while the mortality of those given Remdesivir was 53 per cent.
Four drugs were being trialled in an attempt to combat the major outbreak and two of those were found to have dramatically increased survival rates. The trial took place in four treatment centers in towns in the country’s east, Beni, Katwa, Butembo and Mangina, where the outbreak is at its worst.
Starting last November, patients in four treatment centers in the country’s east, where the outbreak is at its worst, were randomly assigned to receive one of four investigational therapies—either an antiviral drug called remdesivir or one of three drugs that use monoclonal antibodies. Scientists concocted these big, Y-shaped proteins to recognize the specific shapes of invading bacteria and viruses and then recruit immune cells to attack those pathogens.
One of these, a drug called ZMapp, is currently considered the standard of care during Ebola outbreaks. It had been tested and used during the devastating Ebola epidemic in West Africa in 2014, and the goal was to see if those other drugs could outperform it. But preliminary data from the first 681 patients (out of a planned 725) showed such strong results that the trial has now been stopped.
The mortality rates were lower for people who arrived at treatment centres soon after becoming sick. Those given Zmapp had death rates of 24 per cent, Remdesivir had a rate of 33 per cent, Regeneron’s monoclonal anitbody had a mortality rate of 6 per cent and the drug made by Ridgeback Biotherapeutics had 11 per cent.
With the WHO’s announcement a new trial will now kick off, directly comparing Regeneron to mAb114, which is being produced by a Florida-based company called Ridgeback Biotherapeutics. And all Ebola treatment units in the outbreak zone will now only administer the two most effective monoclonal antibody drugs, according to the WHO’s director of health emergencies, Mike Ryan.
“Today’s news puts us one more step to saving more lives,” said Ryan. “The success is clear. But there’s also a tragedy linked to the success. The tragedy is that not enough people are being treated. We are still seeing too many people staying away from treatment centers, people not being found in time to benefit from these therapies.”
Dr Jeremy Farrar, the director of Wellcome and the co-chair of the WHO Ebola therapeutics group, said the next step is to learn more about the two successful drugs.
The more we learn about these two treatments, and how they can complement the public health response, including contact tracing and vaccination, the closer we can get to turning Ebola from a terrifying disease to one that is preventable and treatable.
We won’t ever get rid of Ebola but we should be able to stop these outbreaks from turning into major national and regional epidemics.
Though the four-drug trial has come to an end, an ‘extension phase’ of the study will now begin to directly compare the two monoclonal antibody drugs.