An experimental combination of three humanized monoclonal antibodies targeted at three Ebola virus glycoprotein epitopes, engineered for expression in tobacco plants. ZMapp was found to be protective when administered to nonhuman primates 24-48 hours after infection. Another study showed that the drug was able to rescue nonhuman primates when treatment is initiated up to 5 days after infection. The PALM trial found that ZMapp was inferior to both atoltivimab/maftivimab/odesivimab and ansuvimab at reducing mortality. The World Health Organization (WHO) suggests against treatment with ZMapp as the evidence is very uncertain regarding any true benefits or harms.
A prodrug of adenine nucleotide analog that has potent activity against a variety of filoviruses in primate cell infection models. Initial studies have demonstrated excellent effectiveness as a treatment in nonhuman primates infected with Ebola virus. The PALM trial found that remdesivir was inferior to atoltivimab/maftivimab/odesivimab, ansuvimab, and ZMapp at reducing mortality. The WHO suggests against treatment with remdesivir as the effects on mortality and serious adverse events remains very uncertain. Remdesivir is now being used for the treatment of coronavirus disease 2019 (COVID-19).
Formerly known as T-705, favipiravir is an experimental antiviral drug that selectively inhibits viral RNA-dependent RNA polymerase. It is active against influenza viruses, West Nile virus, yellow fever virus, foot-and-mouth disease virus, as well as other flaviviruses, arenaviruses, bunyaviruses, and alphaviruses. The drug is currently approved in Japan for influenza pandemics, but has been found to be effective against Ebola virus in mouse models. Human phase II trials in Guinea used a higher dose than that used for influenza. The JIKI trial, a multicenter nonrandomized trial undertaken in Guinea in 2014-2015, suggested good tolerability at a higher dose in a low-resource setting, as well as a potential benefit in patients with low viral loads.
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