United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA.
Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, MD, USA.
Lancet Infect Dis. 2020 Sep;20(9):e231-e237. doi: 10.1016/S1473-3099(20)30282-6. Epub 2020 Jun 18.
The PALM trial in the Democratic Republic of the Congo identified a statistically significant survival benefit for two monoclonal antibody-based therapeutics in the treatment of acute Ebola virus disease; however, substantial gaps remain in improving the outcomes of acute Ebola virus disease and for the survivors. Ongoing efforts are needed to develop more effective strategies, particularly for individuals with severe disease, for prevention and treatment of viral persistence in immune-privileged sites, for optimisation of post-exposure prophylaxis, and to increase therapeutic breadth. As antibody-based approaches are identified and advanced, promising small-molecule antivirals currently in clinical stage development should continue to be evaluated for filovirus diseases, with consideration of their added value in combination approaches with bundled supportive care, their penetration in tissues of interest, the absence of interaction with glycoprotein-based vaccines, and filoviral breadth.
刚果民主共和国的 PALM 试验表明，两种基于单克隆抗体的治疗方法在治疗急性埃博拉病毒病方面具有统计学意义上的生存获益；然而，在改善急性埃博拉病毒病的结局和幸存者的结局方面仍存在很大差距。需要继续努力制定更有效的策略，特别是针对重症患者，预防和治疗免疫特权部位的病毒持续存在，优化暴露后预防，并扩大治疗范围。随着抗体为基础的治疗方法的出现和发展，目前处于临床开发阶段的有前途的小分子抗病毒药物也应继续针对丝状病毒病进行评估，考虑它们与捆绑支持性护理的联合治疗方法的附加值、它们在感兴趣的组织中的渗透能力、与糖蛋白疫苗无相互作用以及丝状病毒的广泛程度。
