Scientists hail promise of first effective Ebola treatments

Henrietta Strickland
August 13, 2019

REGN-EB3 and mAb114 "are the first drugs that, in a scientifically sound study, have clearly shown a significant diminution in mortality for people with Ebola virus disease", Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, told AFP.

Fauci explained that the trial was created to include 725 people, but was halted by an independent board when it had enrolled 681 people because at that point, one of the drugs, REGN-EB3 by Regeneron, reached a critical threshold in success, while mAb114 was not far behind.

The treatments, known as REGN-EB3 and an antibody called mAb114, were being tried out in patients with Ebola in the Democratic Republic of Congo, along with antiviral drugs ZMapp and Remdesivir.

The study is an worldwide effort that is co-sponsored and funded by Congo's INRB and the National Institute of Allergy and Infectious Diseases (NIAID), part of the United States' National Institutes of Health.

The randomized, multicenter, controlled trial was created to evaluate the safety and efficacy of 3 antibody-based investigational agents for the treatment of Ebola: REGN-EB3, ZMapp, and mAb114, and 1 small molecule antiviral remdesivir.

The rates for Zmapp and remdesivir were 49 percent and 53 percent respectively.

According to the National Institutes of Health (NIH), in addition to limiting therapeutics to REGN-EB3 and mAb114, patients who were randomized to ZMapp or remdesivir in the last 10 days now have the option, at the discretion of their treating physician, to receive either REGN-EB3 or mAb114.

"It is through this type of rapidly implemented, rigorous research that we can quickly and definitively identify the best treatments and incorporate them into the Ebola outbreak response", they said.

In comparison, two-third of the patients who got remdesivir and almost three-fourth on ZMapp survived.

The Congo treatment trial, which began in November past year, is being carried out by an global research group co-ordinated by the World Health Organization (WHO).

Ebola has been spreading in eastern DRC since August 2018 in an outbreak that has so far killed at least 1,800 people. Efforts to control it have been hampered by militia violence and some local resistance to outside help.

Mike Ryan, head of the WHO's emergencies programme, said the trial's positive findings were encouraging but would not be enough on their own to bring the epidemic to an end. "It gives us a new tool in our toolbox against Ebola, but it will not in itself stop Ebola", he told reporters. The differences in the response of the patients to these two treatments in this initial test were "negligible".

Jeremy Farrar, director of Britain's Wellcome Trust research charity, said the development would "undoubtedly save lives", adding: "Thanks to this trial, we are starting to understand which treatments to offer to patients in this and future outbreaks".

"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".

Some 681 patients at four separate treatment centres in the DRC have already been enrolled in the treatment clinical trial, Fauci said. The study aims to enrol a total of 725. When the board met on August 9, it recommended that the study be halted, as individuals receiving REGN-EB3 or mAb114 had a greater chance of survival compared with the other treatment arms.

Other reports by Click Lancashire

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