A clinical trial for a possible treatment for Ebola started in Guinea on December 17. The trial is led by the French medical research institute INSERM and is taking place at the Doctors Without Borders/Médecins Sans Frontières (MSF) Ebola treatment center in Guéckédou, in the east of the country. Although every experimental treatment for Ebola patients offers hope, MSF remains prudent. There’s no guarantee that the drug will be effective and safe, and, even if it is, it will not mean the end of the epidemic which continues to spread in the three most affected countries of West Africa.
The trial aims to include as many Ebola-positive patients presenting at the MSF treatment center as possible. There will be no control group (group of patients who do not receive the treatment) in this study, as it is considered unethical to deny a group of patients the higher chance of survival that may come with the new treatment, especially given the high mortality rate of Ebola. Instead, the outcomes of the patients will be measured against those of MSF patients admitted earlier this year, before the trial began. The first conclusive results are not expected before the first trimester of 2015.
All new patients arriving at the MSF Ebola treatment center in Guéckédou are informed about the possibility of receiving the experimental treatment and can elect to participate in the study or not. Those who do not wish to be given the new treatment will receive the same supportive care as those who do, but without the administration of the trial drug.
The drug being used in Guéckédou is favipiravir, an antiviral drug produced by the Japanese company Toyama/FujiFilm. This drug has had good results against Ebola in animal studies and good safety results in humans when used as treatment for another viral infection. But, as the drug has never been studied in humans with Ebola, it is important to wait for the results of the trial before declaring favipiravir a treatment for the disease.
If favipiravir is shown to be safe and effective, it will be made accessible to Ebola patients in other Ebola treatment centers through advancing the trial to the next phase. This means that after approval from national authorities and independent ethics committees more Ebola-positive patients in West Africa will be started on the treatment.
A safe and effective treatment for Ebola will prevent many patients from dying, but it will not change the course of the epidemic. Interventions like early admission of patients in specialized centers, thorough and accurate contact tracing, tailored health promotion, and necessary hygiene and sanitation measures will continue to be the most important strategies in ending the outbreak. Research into other treatments including vaccines and new diagnostics will also remain important.
