Study leaders who put to the test four separate experimental therapies for use against Ebola virus disease (EVD) say that all have proven effective after halting a clinical trial of the treatments in August.
“Response teams have faced unprecedented challenges in ongoing efforts to save lives and control the outbreak of Ebola in a highly insecure region of the Democratic Republic of the Congo,” Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), said. “Although effective treatments alone will not end this outbreak, the PALM study findings identify the first efficacious treatments for Ebola virus disease and therefore mark a significant step forward in improving care for Ebola patients.”
PALM refers to a Kiswahili phrase meaning “together save lives.” In that study, 681 people infected with Ebola participated at four Ebola treatment centers in the Democratic Republic of the Congo (DRC). All drugs involved were tested against another, ZMapp, with two proving even more effective and one performing similarly. The drugs were administered by intravenous infusions, generally well tolerated, and all increased survival in the face of EVD.
“The PALM trial results confirm that it is extremely important for people who have symptoms of Ebola to go to a treatment center as soon as possible to receive advanced supportive care and life-saving therapeutics and increase their chances of survival,” Dr. Jean-Jacques Muyembe-Tamfum, co-principal investigator, said.
While these drugs increased survival, the costs should still be noted. Among patients, 50 percent of those treated with ZMapp still died, compared against 53 percent of those using the drug remdesivir, 35 percent using mAb114, and 34 percent administered REGN-EB3. Those with less virus in their blood when they began treatment also saw better results. Highlighting the importance of early diagnosis and treatment, those patients who enrolled in the trial one day after the reported onset of symptoms had a mortality rate of just 19 percent, against the 47 percent of those arriving after five days.
Investigators noted the odds of death increased by 11 percent for each day a patient delayed treatment.
Efforts were organized by the World Health Organization (WHO) and funded by a mix of the DRC’s National Institute for Biomedical Research and Ministry of Health, along with NIAID. The results were published in the New England Journal of Medicine.