Maladie à virus Ebola : actualités thérapeutiques

The recent outbreak of Ebola virus disease (EVD), that started in March 2014 in Guinea and ended in January 2016 in Liberia, is the largest and deadliest Ebola outbreak ever reported. In the absence of approved treatments and vaccines against Ebola, new therapeutic and preventive strategies have been evaluated during this epidemic. Late 2014, the World Health Organization listed all drug/vaccine candidates that had proven efficacy in vitro or in animal models. The priority for clinical research was given: (i) to drug candidates such as antiviral agents (favipiravir and BCX4430), agents from immunotherapy such as monoclonal antibodies (ZMapp and MIL-77) and type I interferons, agents from antisense therapy such as RNA interference-based drugs (TKM-Ebola and AVI-7537) and anticoagulant drugs (rNAPc2); (ii) to vaccine candidates such as the recombinant vaccines rVSV-ZEBOV and ChAd3-ZEBOV. Favipiravir and ZMapp inhibit respectively viral replication and virus fusion with the host cell and are to-date the most promising drugs in the fight against Ebola. GS-5734 a nucleoside analog at early stages of development is also considered as a potential therapeutic candidate. Only rVSV-ZEBOV vaccine has achieved encouraging results in terms of safety and efficacy in humans. Clinical trials developed and conducted in the health emergency context should help to design future studies.