Musafiri Sanctus, Siddig Emmanuel Edwar, Nkuranga John Baptist, Rukundo Athanase, Mpunga Tharcisse, Sendegeya Augustin, Twagirumugabe Theogene, Ahmed Ayman, Muvunyi Claude Mambo
University Teaching Hospital of Kigali (CHUK), Kigali KN 4 Ave, Rwanda.
School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali 3900, Rwanda.
Pathogens. 2025 Mar 27;14(4):322. doi: 10.3390/pathogens14040322.
During the current outbreak of Marburg virus disease (MVD) in Rwanda, we synthesized evidence from the literature to improve case management. Accordingly, experimental treatment was offered to patients under close follow-up. Remdesivir alone or in combination with monoclonal antibody treatment (MBP091) complemented with supportive care has improved the clinical outcomes of patients. Additionally, we have identified several experimental therapies currently under investigation, including antiviral drugs such as favipiravir, galidesivir, obeldesivir, and remdesivir, along with monoclonal and polyclonal antibodies (e.g., polyclonal IgG, monoclonal antibody MR-78-N; MR82-N; MR191-N; monoclonal antibodies MR186-YTE and MBP091). Furthermore, substantial progress is being made in vaccine development, with promising candidates including adenovirus-vectored vaccines, DNA vaccines, and the recombinant vesicular stomatitis virus (rVSV) vaccine. Moreover, innovative preventive and treatment strategies-such as synthetic hormones like estradiol benzoate, small interfering RNA (siRNA), interferon-β therapy, and phosphorodiamidate morpholino oligomers-are emerging as potential options for MVD management. Further investment is needed to accelerate research and optimize these therapeutics and preventive modalities. Additional epidemiological, preclinical, and clinical studies are warranted to generate the evidence required to inform policymaking, resource mobilization, and the implementation of cost-effective interventions for the prevention, control, and treatment of MVD.
在卢旺达当前爆发马尔堡病毒病(MVD)期间,我们综合了文献中的证据以改善病例管理。因此,在密切随访下为患者提供了试验性治疗。单独使用瑞德西韦或与单克隆抗体治疗(MBP091)联合使用并辅以支持性护理已改善了患者的临床结局。此外,我们还确定了目前正在研究的几种试验性疗法,包括抗病毒药物,如法匹拉韦、加利地韦、奥贝德西韦和瑞德西韦,以及单克隆和多克隆抗体(例如多克隆IgG、单克隆抗体MR-78-N;MR82-N;MR191-N;单克隆抗体MR186-YTE和MBP091)。此外,疫苗研发正在取得重大进展,有前景的候选疫苗包括腺病毒载体疫苗、DNA疫苗和重组水疱性口炎病毒(rVSV)疫苗。此外,创新的预防和治疗策略,如苯甲酸雌二醇等合成激素、小干扰RNA(siRNA)、干扰素-β疗法和磷酰二胺吗啉代寡聚物,正成为MVD管理的潜在选择。需要进一步投资以加速研究并优化这些治疗方法和预防手段。有必要开展更多的流行病学、临床前和临床研究,以生成制定政策、筹集资源以及实施具有成本效益的MVD预防、控制和治疗干预措施所需的证据。