Ebola: New WHO Treatment Recommendations

GENEVA ― Following a systematic review and meta-analysis of randomized clinical trials of the disease's therapeutics, the World Health Organization (WHO) has made strong recommendations for two monoclonal antibody treatments, mAb114 (Ansuvimab, Ebanga) and REGN-EB3 (Inmazeb), for the treatment of Ebola virus disease (EVD). At the same time, the organization calls on the global community to increase access to these lifesaving medicines to stop Ebola from being fatal, which it too often is.

This recommendation follows initial WHO guidelines on the treatment of EVD.

"The new guidance complements clinical care guidance that outlines the optimized supportive care Ebola patients should receive, from the relevant tests to administer, to managing pain, nutrition and co-infections, and other approaches that put the patient on the best path to recovery," the WHO writes.

For All Ebola-Positive Patients

The two recommended therapeutics, mAb114 (Ansuvimab, Ebanga) and REGN-EB3 (Inmazeb), have demonstrated clear benefits and therefore can be used for all patients who have been confirmed to have EVB, including older people, pregnant and breastfeeding women, children, and neonates born to mothers with confirmed Ebola within the first 7 days after birth. Patients should receive recommended neutralizing monoclonal antibodies as soon as possible after laboratory confirmation of diagnosis.

During a press briefing, Janet Diaz, MD, head of the WHO's clinical management unit, stated that the two therapeutics significantly reduce the death rate from Ebola, reports France Info.

These treatments may save from 230 to 400 lives for every 1000 people infected.

"Advances in supportive care and therapeutics over the past decade have revolutionized the treatment of Ebola. Ebola virus disease used to be perceived as a near certain death. However, that is no longer the case," said Robert Fowler, MD, University of Toronto, Canada, and co-chair of the guideline development group, adding: "Provision of best supportive medical care to patients, combined with monoclonal antibody treatment ― MAb114 or REGN-EB3 ― now leads to recovery for the vast majority of people."

Access to mAb114 and REGN-EB3 remains challenging, especially in resource-poor areas, where patients need them the most.

It should be noted that "there is also a recommendation on therapeutics that should not be used to treat patients: these include ZMapp and remdesivir."

Regeneron's Inmazeb, which was previously known as REGN-EB3, consists of three monoclonal antibodies of similar structure ― atoltivimab, maftivimab, and odesivimab ― which bind distinct non-overlapping epitopes on the Zaire ebolavirus glycoprotein. The three-antibody combination neutralizes the Ebola virus by blocking it from entering host cells and/or by bringing in other immune cells to target infected cells and clear them from the body.

Ebanga (ansuvimab-zykl) is a recombinant, human monoclonal antibody with antiviral activity against Zaire ebolavirus. This medicine binds to the glycoprotein expressed on the surface of the Ebola virus and prevents it from attaching to and entering host cells.

It was initially developed by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. In December 2018, American biotechnology company Ridgeback Biotherapeutics was issued a license for Ebanga (previously known as mAb114) by the NIAID as part of a patent license agreement for monoclonal antibody–associated intellectual property.

In 2020, the US Food and Drug Administration approved both therapeutics as treatments for Ebola.

This article was originally published on Medscape French edition.

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Cite this: Ebola: New WHO Treatment Recommendations - Medscape - Sep 14, 2022.