a Division of Infectious Diseases, Department of Medicine , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
b Division of Medicine , United States Army Medical Research Institute of Infectious Diseases , Frederick , MD , USA.
Expert Rev Anti Infect Ther. 2018 Jan;16(1):67-76. doi: 10.1080/14787210.2018.1413937. Epub 2017 Dec 20.
During the 2014-2016 Ebolavirus (EBOV) outbreak, several candidate therapeutics were used in EBOV-infected patients in clinical trials and under expanded access for emergency use. This review will focus briefly on medications used during the outbreak. We will discuss current therapeutic candidates and their status and will then turn to a related and essential topic: supportive care and the standard of care for filovirus infected patients. Potential benefits and pitfalls of combination therapies for filoviruses will be discussed. Areas covered: Clinical trials of therapeutics targeting EBOV; clinical usage of therapeutics during recent EBOV outbreak; potential need for combination therapy; role of supportive care in treatment of Ebola virus disease (EVD). Expert commentary: In the absence of another large scale EBOV outbreak, the path to therapeutic product licensure in the United States of America (USA) would need to be via the FDA Animal Rule. However, human data may be needed to supplement animal data. The future of filovirus therapeutics may therefore benefit by establishing the ability to implement clinical trials in an outbreak setting in a timely fashion. Supportive care guidelines for filovirus infection should be defined and established as standard of care for treatment of EVD.
在 2014-2016 年埃博拉病毒（EBOV）爆发期间，几种候选疗法在临床试验中用于 EBOV 感染患者，并根据扩大的紧急用途获得了许可。这篇综述将简要聚焦于在疫情期间使用的药物。我们将讨论当前的治疗候选药物及其现状，然后转向一个相关且重要的话题：支持性护理以及丝状病毒感染患者的标准护理。我们将讨论联合疗法治疗丝状病毒的潜在益处和陷阱。涵盖的领域：针对 EBOV 的治疗方法的临床试验；最近 EBOV 爆发期间治疗方法的临床应用；对联合疗法的潜在需求；支持性护理在治疗埃博拉病毒病（EVD）中的作用。专家评论：在没有另一次大规模 EBOV 爆发的情况下，在美国获得治疗产品许可的途径将需要通过 FDA 动物规则。然而，可能需要补充动物数据的人类数据。因此，丝状病毒疗法的未来可能会通过及时建立在疫情环境中实施临床试验的能力而受益。丝状病毒感染的支持性护理指南应作为 EVD 治疗的标准护理加以确定和制定。
