Table 2.
Marburg countermeasures – treatment with antivirals.
| Therapy | Manufacturer or source/contact | Description | NHP studies | Human use (INDs, case reports, phase 1 or 2) | Phase 3/RCTs | Regulatory approvals | Notes/special populations |
|---|---|---|---|---|---|---|---|
| Antivirals | |||||||
| NP-718-LNP | Tekmira/Arbutus Biopharma, Vancouver, BC, Canada | Small-interfering RNA targets nucleoprotein | 100% survival (16 NHPs) with treatment 30 min–2 h post infection | Multiple microRNAs tested in humans, but not this product or any others for filoviruses | |||
| BCX4430 (Galidesivir) | Biocryst Pharmaceuticals, Durham, NC | Synthetic nucleoside analogue that inhibits viral RNA polymerase | 17/18 survive with treatment 1–48 h post infection. Also shown protection for Ebola |
Phase 1 study completed 2016. Results not published | |||
| AVI-7288 alone or in combination with AVI-7287 as AVI-6003 | Sarepta Therapeutics, Cambridge, MA | Phosphorodiamidate morpholino oligomers with positive charges - AVI 7288/7287 Target NP/VP24 gene, respectively | 83–100% protection with treatment 24–96 h post infection | With AVI-6003, no significant safety signals in two RCTs with 70 subjects | |||
| Favipiravir (T-705) | Toyama Chemical Company, Ltd, Japan | Synthetic guanidine nucleoside analog with broad-spectrum antiviral activity against multiple families of RNA viruses | 5/6 survived when begun IV on day of challenge, but not with oral doses | Inconclusive results in West Africa (JIKI) Ebola trial using historical controls. Lower viremia (Ct ≥20) fared better | Licensed in Japan for influenza. Has had broad human use | ||
| GS-5734 (remdesivir) | Gilead Sciences, Foster City, CA | Monophosphoramidate prodrug of an adenosine analog with broad antiviral activity. Inhibits Marburg in vitro | Protected 50 and 83% of MARV-infected NHPs against lethal disease when initiated up to 4–5 days post-infection with Marburg | Female nurse recovered after treated for Ebola meningoencephalitis relapse. Multiple human trials ongoing for COVID-19. Used for MEURI compassionate use in 2018–2019 DRC outbreak. Lower survival than antibody-derived products in PALM RCT for 2018/19 Ebola outbreak in DRC |
35–36-week-old infant treated whose mother was infected with Ebola during pregnancy | ||