'Ebola Is Now a Disease We Can Treat.' How a Cure Emerged From a War Zone.
BUTEMBO, Democratic Republic of Congo—The Ebola virus kills in terrifying ways, shutting down the body’s organs and draining victims of the fluids that keep them alive. In outbreaks, it has claimed as many as 9 in 10 patients. In a medical breakthrough that compares to the use of penicillin for war wounds, two new drugs are saving lives from the virus and helping uncover tools against other deadly infectious diseases. They were proven effective in a gold-standard clinical trial conducted by an international coalition of doctors and researchers in the middle of armed violence.
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Researchers tested four experimental drugs, and two were most effective. The treatments are remarkable for their potential to save lives, as well as for the way they came about. The trial was conducted at four Ebola treatment centers, essentially tent-sided field hospitals, scattered across a violent swath of northeastern Congo during the world’s second-largest outbreak of the disease. In addition to the threat from the contagious virus, researchers dodged attacks by warring local groups. Two of the treatment centers were set on fire. Despite the obstacles, doctors healed patients sick with Ebola, often just days after a single intravenous dose.
Congolese virologist Jean-Jacques Muyembe Tamfum had long believed that antibodies—proteins that the immune system produces to fight infection—could bolster patients’ defenses against Ebola. He faced doubts from scientists skeptical about drawing conclusions from his research. In the trial, patients given a single-antibody drug had a 35% mortality rate, according to results presented at an infectious-diseases conference this month in Washington, D.C., compared with as high as 90% without treatment. The NIAID-led drug, mAb114, was developed from an antibody of an Ebola survivor found by Dr. Muyembe. Among patients treated with a drug made of three antibodies by Regeneron Pharmaceuticals Inc., called REGN-EB3, 34% died. Trial patients who were treated with either drug soon after falling ill fared even better, preliminary results found. The overall results included patients who were sick for days before seeking help.
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Dr. Muyembe set out on his path to an Ebola treatment during the 1995 outbreak. He transferred blood from five survivors to eight patients, hoping that the antibodies that kept some people alive would keep others from dying. Seven of the patients who received the blood transfusion recovered. He published the results in a scientific journal in 1999. Other researchers said the study was small and had failed to include a control group, a comparison set of patients who weren’t given the treatment, to fully test its efficacy. In 2005, Dr. Muyembe met with NIAID scientist Barney Graham, who had come to see Dr. Muyembe about collaborating on monkey pox and HIV vaccine research. Their conversation turned to Ebola, and Dr. Muyembe suggested the NIAID study antibodies from one of the Ebola survivors who had donated blood.
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As family members died one by one, Mr. Mubiala developed a fever and grew weak. “I had a feeling that I will die soon,” said Mr. Mubiala. Only he and a sister lived. After recovering, he donated his blood to Dr. Muyembe for the study, and, assuming he was immune to Ebola, spent the next months caring for others with the disease. Scientists suspected Mr. Mubiala had potent antibodies because he had been severely ill, then recovered and was likely exposed again to the virus as he helped Ebola patients. In late 2006, Mr. Mubiala traveled to the NIAID’s Vaccine Research Center in Bethesda, Md., and gave blood samples. One of Dr. Muyembe’s researchers worked with scientists there over several years to identify antibodies from Mr. Mubiala that disabled the virus. From one, they developed mAb114.
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All 13 patients in Mangina survived. Doctors soon began administering mAb114, REGN-EB3 and other experimental drugs. They were given to patients under WHO guidelines allowing experimental therapeutics during deadly outbreaks. Researchers moved quickly to design the clinical trial that confirmed what Dr. Muyembe first suspected—that antibodies from those who survived the virus held the key to saving others.
https://www.wsj.com/articles/ebola-is-now-a-disease-we-can-treat-how-a-cure-emerged-from-a-war-zone-11572446873 (paid subscription)