Sweiti Hussein, Ekwunife Obinna, Jaschinski Thomas, Lhachimi Stefan K
Institute of Health Services Research and Health Economics, School of Medicine, Heinrich-Heine University Dû¥sseldorf, Dû¥sseldorf, Germany.
Surgical Department, Klinikum Frankfurt HûÑchst, Frankfurt, Germany.
Curr Ther Res Clin Exp. 2017 Feb 2;84:10-21. doi: 10.1016/j.curtheres.2017.01.007. eCollection 2017.
The Ebola virus has been responsible for numerous outbreaks since the 1970s, with the most recent outbreak taking place between 2014 and 2016 and causing an international public health emergency. Ebola virus disease (EVD) has a high mortality rate and no approved targeted treatment exists to date. A number of established drugs are being considered as potential therapeutic agents for the treatment of EVD.
We aimed to identify potential drug repositioning candidates and to assess the scientific evidence available on their efficacy.
We conducted a systematic literature search in MEDLINE, Embase, and other relevant trial registry platforms for studies published between January 1976 and January 2017. We included drug screening, preclinical studies, and clinical studies on repurposed drugs for the treatment of EVD. The risk of bias for animal studies and nonrandomized clinical studies was assessed. The quality of reporting for case series and case reports was evaluated. Finally, we selected drugs approved by established regulatory authorities, which have positive in vitro study outcomes and at least one additional animal or clinical trial.
We identified 3301 publications, of which 37 studies fulfilled our inclusion criteria. Studies were highly heterogeneous in terms of study type, methodology, and intervention. The risk of bias was high for 13 out of 14 animal studies. We selected 11 drugs with potential anti-EVD therapeutic effects and summarized their evidence.
Several established drugs may have therapeutic effects on EVD, but the quality and quantity of current scientific evidence is lacking. This review highlights the need for well-designed and conducted preclinical and clinical research to establish the efficacy of potential repurposed drugs against EVD.
自20世纪70年代以来，埃博拉病毒已引发多次疫情，最近一次疫情发生在2014年至2016年期间，造成了国际公共卫生紧急事件。埃博拉病毒病（EVD）死亡率很高，迄今为止尚无经批准的靶向治疗方法。一些已上市药物正被考虑作为治疗EVD的潜在治疗药物。
我们旨在确定潜在的药物重新定位候选药物，并评估现有关于其疗效的科学证据。
我们在MEDLINE、Embase和其他相关试验注册平台上进行了系统的文献检索，以查找1976年1月至2017年1月期间发表的研究。我们纳入了关于用于治疗EVD的重新利用药物的药物筛选、临床前研究和临床研究。评估了动物研究和非随机临床研究的偏倚风险。评估了病例系列和病例报告的报告质量。最后，我们选择了已获既定监管机构批准、具有阳性体外研究结果且至少有一项额外动物或临床试验的药物。
我们识别出3301篇出版物，其中37项研究符合我们的纳入标准。研究在研究类型、方法和干预方面高度异质性。14项动物研究中有13项偏倚风险很高。我们选择了11种具有潜在抗EVD治疗作用的药物并总结了其证据。
几种已上市药物可能对EVD有治疗作用，但目前科学证据的质量和数量不足。本综述强调需要精心设计和开展临床前及临床研究，以确定潜在重新利用药物对EVD的疗效。
