Antiviral protects monkeys from Ebola virus

After three days post-infection with Ebola virus, 100% of rhesus monkeys survived after being given antiviral treatment. In addition, the monkeys exhibited a reduction in viral load as well as a decrease in the physical signs of the disease. This research was conducted by the US Army Medical Research Institute of Infectious Diseases.

The initial compound being worked with was a precursor to GS-5734, which is a small antiviral agent. GS-5734 is a novel prodrug which the Ebola virus by blocking the virus’s ability to replicate it’s genetic material.

The thing I found most interesting about this discovery is that GS-5734 use is favorable in humans because it can be made using a well-controlled chemical procedure and can be produced in mass quantities. I think that this research should be further studied to see how this antiviral can be used to cure the Ebola virus in humans. It will be interesting to see how soon this can be implemented. My question for the class is: How do you think we should go about testing this antiviral in human subjects?

Reference:

Travis K. Warren, Robert Jordan, Michael K. Lo, Adrian S. Ray, Richard L. Mackman, Veronica Soloveva, Dustin Siegel, Michel Perron, Roy Bannister, Hon C. Hui, Nate Larson, Robert Strickley, Jay Wells, Kelly S. Stuthman, Sean A. Van Tongeren, Nicole L. Garza, Ginger Donnelly, Amy C. Shurtleff, Cary J. Retterer, Dima Gharaibeh, Rouzbeh Zamani, Tara Kenny, Brett P. Eaton, Elizabeth Grimes, Lisa S. Welch, Laura Gomba, Catherine L. Wilhelmsen, Donald K. Nichols, Jonathan E. Nuss, Elyse R. Nagle, Jeffrey R. Kugelman, Gustavo Palacios, Edward Doerffler, Sean Neville, Ernest Carra, Michael O. Clarke, Lijun Zhang, Willard Lew, Bruce Ross, Queenie Wang, Kwon Chun, Lydia Wolfe, Darius Babusis, Yeojin Park, Kirsten M. Stray, Iva Trancheva, Joy Y. Feng, Ona Barauskas, Yili Xu, Pamela Wong, Molly R. Braun, Mike Flint, Laura K. McMullan, Shan-Shan Chen, Rachel Fearns, Swami Swaminathan, Douglas L. Mayers, Christina F. Spiropoulou, William A. Lee, Stuart T. Nichol, Tomas Cihlar, Sina Bavari. Therapeutic efficacy of the small molecule GS-5734 against Ebola virus in rhesus monkeysNature, 2016; DOI:1038/nature17180

 

 

Experimental Treatment with Favipiravir for Ebola Virus Disease (the JIKI Trial): A Historically Controlled, Single-Arm Proof-of-Concept Trial in Guinea

As Ebola virus disease (EVD) was at it’s peak, World Health organization brought up a list of drugs that could potentially be researched to treat Ebola. This research was originally set-up as a randomised trial, but due to high mortality rate, it was found to be unethical for many reasons. The main reason this research was made to be randomized was to avoid any implications that could arise from patients not recieveing treatment drug when they need to as it could lead to less people believing in the healthcare system. So, this research was randomized in which 99 patient’s data was represented in this study.

The study was done using Favipiravir, an antiviral that is used to treat severe influenza, to research it’s efficacy on patients with EVD. All of the patients were given either standard therapy treatment or treatment with experimental drug to see it’s efficacy. During this study of being non-randomized, it was seen that the patient’s with Ct count of less than 20 had high mortality rate than patients with Ct count of over 20. The data extracted from these patients was sufficient to consider whether this drug was efficacious for patients to use in the future, as this study was non-randomized and the the mortality of the patient was as predicted.

This study had no real results, but showed some potential of setting up a clinic for EVD patients. Knowing the ethical implications along with the clinical aspects of treating ebola is what this paper was implying. Although there was not any presentable data that could help with treatment of EVD, this paper helps understand some of the important aspects that a researcher will face if Ebola patients were used in a study. Would you use Ebola patients for your study? How can you justify if a person gets the treatment dose or not having randomized trial?

 

Sissoko D, Laouenan C, Folkesson E. (2016).Experimental Treatment with Favipiravir for Ebola Virus Disease (the JIKI Trial): A Historically Controlled, Single-Arm Proof-of-Concept Trial in Guinea. 2016 Mar 1;13(3):e1001967.

Published online first.