Ebola is now largely curable, new clinical trials suggest

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The Democratic Republic of Congo is suffering from a major epidemic of Ebola since August 2018.
In November 2018, a clinical trial began to compare the effectiveness of four Ebola treatments.
Two of these treatments – based on monoclonal antibodies – are almost twice as effective as the standard treatment.

In August 2018, an Ebola outbreak hit a conflict zone in North Kivu province in the Democratic Republic of Congo. It has spread rapidly elsewhere in the country with 81.3 million inhabitants, many of whom are involved in battles over the precious minerals of the DRC. In April, the epidemic had become the second worst ever recorded and by June, it had killed at least 1,357 Congolese.

But a recent clinical trial comparing the effectiveness of four Ebola treatments brings good news.

"From now on, we will no longer say that Ebola is incurable," said Dr. Jean-Jacques Muyembe, director general of the National Institute for Biomedical Research in the DRC, who oversaw the trial. "These advances will save thousands of lives."

In November 2018, DRC doctors began randomly assigning one out of four treatment to Ebola patients: an antiviral drug called remdesivir or one of three monoclonal antibody-based drugs, which consists of a set of immune cells cloned from a mother cell. ZMapp – one of three drugs using monoclonal antibodies – has long been considered the most effective treatment against Ebola. In the clinical trial, it reduced the death rates of Ebola patients to about 49%. (Patients who receive no treatment have a mortality rate of about 75%.)

But two other drugs of the same class – a cocktail of monoclonal antibodies manufactured by a company named Regeneron and an antibody called mAb114 manufactured by the Vaccine Research Center of the National Institute of Allergy and Infectious Diseases – were much more effective, resulting in overall mortality. rates of 29 and 34 percent, respectively. These drugs were developed by giving Ebola mice and then extracting the antibodies produced by the mice. The scientists then modified these antibodies so that the human body accepts them. Both drugs will now be administered in all treatment centers in the DRC.

An illustration of how to safely bury people who died of Ebola. Image Source: CDC's Center for Global Health

Monoclonal antibody drugs were particularly successful in curing the Ebola virus when patients took them shortly after becoming ill, with the Regeneron mortality rate reduced to only 6%. But one problem is that most Ebola patients in the DRC wait an average of four days before going to the hospital, which decreases the chances of survival and increases the chances of transmission of the disease – through fluids – to people nearby.

But health experts are optimistic about new 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 make Ebola a terrifying disease that can be avoided and treated, "said Dr. Jeremy. Farrar, co-chair of the World Health Organization's Ebola Therapy Group, said The Guardian. "We will never be able to get rid of Ebola, but we should be able to prevent these outbreaks from turning into major epidemics at the national and regional levels."