Monoclonal antibodies for the treatment of Ebola virus disease.
To date, the management of patients with suspected or confirmed Ebolavirus disease (EVD) depends on quarantine, symptomatic management and supportive care, as there are no approved vaccines or treatments available for human use. However, accelerated by the recent large outbreak in West Africa, significant progress has been made towards vaccine development but also towards specific treatment with convalescent plasma and monoclonal antibodies. Areas covered: We describe recent developments in monoclonal antibody treatment for EVD, encompassing mAb114 and the MB-003, ZMAb, ZMapp™ and MIL-77E cocktails. Expert opinion: Preventive measures, are, and will remain essential to curb EVD outbreaks; even more so with vaccine development progressing. However, research for treatment options must not be neglected. Small-scale animal and individual human case studies show that monoclonal antibodies (mAbs) can be effective for EVD treatment; thus justifying exploration in clinical trials. Potential limitations are that high doses may be needed to yield clinical efficacy; epitope mutations might reduce efficacy; and constant evolution of (outbreak-specific) mAb mixtures might be required. Interim advice based on the clinical experience to date is that treatment of patients with mAbs is sensible, provided those could be made available in the necessary amounts in time.
a Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.
A L
AL
Moekotte
a Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.
M A M
MA
Huson
b Lion Heart Medical Center , Yele , Sierra Leone.|c Lion Heart Medical Research Unit , Yele , Sierra Leone.
A J
AJ
van der Ende
d Centre de Recherches Médicales en Lambaréné (CERMEL) , Lambaréné , Gabon.|e Institute of Tropical Medicine , University of Tübingen , Tübingen , Germany.
S T
ST
Agnandji
b Lion Heart Medical Center , Yele , Sierra Leone.|c Lion Heart Medical Research Unit , Yele , Sierra Leone.
E
E
Huizenga
a Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.|c Lion Heart Medical Research Unit , Yele , Sierra Leone.
A
A
Goorhuis
a Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.|c Lion Heart Medical Research Unit , Yele , Sierra Leone.|d Centre de Recherches Médicales en Lambaréné (CERMEL) , Lambaréné , Gabon.|e Institute of Tropical Medicine , University of Tübingen , Tübingen , Germany.
M P
MP
Grobusch
D000818:Animals; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use*; D004196:Disease Outbreaks; D015195:Drug Design; D046129:Ebola Vaccines / Q000276:immunology; D000939:Epitopes / Q000235:genetics; D019142:Hemorrhagic Fever, Ebola / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D009154:Mutation
D000911:Antibodies, Monoclonal; D046129:Ebola Vaccines; D000939:Epitopes
Ebolavirus disease; MB-003; MIL-77E; ZMAb; ZMappTM; mAb114; monoclonal antibodies; therapy