Ebola that can now be cured after trials of drugs in the DRC, say researchers International News
Ebola can no longer be called an incurable disease, researchers have said, after two out of four drugs tried in the Great Outbreak of the Democratic Republic of Congo were found to have significantly reduced the death rate.
ZMapp, used during the massive Ebola epidemic in Sierra Leone, Liberia and Guinea, has been dropped along with Remdesivir after two monoclonal antibodies, blocking the virus, had significantly more effect, says the World Health Organization and the US National Institute of Allergy and Infectious Diseases, which were co-sponsors of the trial.
The trial in the DRC, which started in November, has now been stopped. All Ebola treatment units will now use the two monoclonal antibody drugs.
"From now on, we will no longer say that Ebola is incurable," said Prof Jean-Jacques Muyembe, director of the National Institute for Research Biomedical in the DRC, who has overseen the trial. "These advances will help save thousands of lives."
One of the biggest obstacles to fighting the years-long DRC outbreak, the second largest ever and now with 2,800 cases, has been the reluctance of those who fall ill to seek treatment.
It has not helped that the chances of survival have been low – up to 70% of those infected in the DRC have died. Muyembe said many people saw family members walk into an Ebola treatment center and come out dead.
"Now that 90% of patients can enter the treatment center and get completely cured, they will begin to believe in it and build trust in the population and society," he said.
Anthony Fauci, the director of the US NIAID, said that the total mortality of those given ZMapp in the four-center trial was 49%, while that of Remdesivir was 53%. A monoclonal antibody drug made by Regeneron had the lowest overall death rate of 29%, while the monoclonal antibody 114 made by Ridgeback Biotherapeutics had a mortality rate of 34%.
But the results of people arriving at a treatment center soon after falling ill rather than staying at home were even more impressive – with death rates of 24% on ZMapp, 33% with Remdesivir, 11% with 114, and just 6 % with Regeneron's drug.
On average, people who get sick do not show up at a four-day treatment center, said Dr. Michael Ryan of the World Health Organization. This reduces their chances of survival and makes it likely that the virus, spread through bodily fluids, will be transmitted to their families.
"The numbers may change," Fauci said. "Not all the data is collected." The two monoclonal antibodies will both now be used in each DRC treatment center.
Fauci paid tribute to all those involved in the experiment in four cities: Beni, Katwa, Butembo and Mangina. Voluntary organizations including the International Medical Corps and Médecins Sans Frontières "put life on the line every day to care for patients under extremely difficult conditions in the area where the outbreak occurs," he said.
Clinical studies under epidemic conditions are difficult – even more so in Ebola outbreaks, where medical personnel must wear protective suits and all patients must be isolated.
"This trial – the first multidisciplinary randomized trial for ebola – has occurred despite such extremely complex and challenging circumstances," said Dr. Jeremy Farrar, director of Wellcome and co-chair of the WHO's Ebola Therapeutic Group. "A prolonged outbreak like this is taking a terrible toll on the communities affected, and it is a sign of how difficult this epidemic has been to verify that enough patients have already been treated to tell us more about the effects of these four drugs. . "
The trial will have saved lives, he said. The next phase will reveal more about which of the two works best in certain settings." The more we learn about these two treatments and how they can complement the response to public health , including contact tracking and vaccination, the closer we can get to making Ebola from a fearsome disease to one that can be prevented and treated. We will never get rid of the Ebola, but we should be able to stop these outbreaks from turning into major national and regional epidemics, "he said.