A systematic review of Ebola virus disease outbreaks and an analysis of the efficacy and safety of newer drugs approved for the treatment of Ebola virus disease by the US Food and Drug Administration from 2016 to 2020

Palanisamy Sivanandy; Pee Hui Jun; Lai Weng Man; Ng Sin Wei; Nicole Foo Kar Mun; Celestine Ang Jia Yii; Charissa Cheah Xiao Ying

doi:10.1016/j.jiph.2022.01.005

A systematic review of Ebola virus disease outbreaks and an analysis of the efficacy and safety of newer drugs approved for the treatment of Ebola virus disease by the US Food and Drug Administration from 2016 to 2020

J Infect Public Health. 2022 Mar;15(3):285-292. doi: 10.1016/j.jiph.2022.01.005. Epub 2022 Jan 21.

Authors

Palanisamy Sivanandy¹, Pee Hui Jun², Lai Weng Man², Ng Sin Wei², Nicole Foo Kar Mun², Celestine Ang Jia Yii², Charissa Cheah Xiao Ying²

Affiliations

¹ Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia. Electronic address: sivapalanisamy@yahoo.co.in.
² School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia.

PMID: 35085865
DOI: 10.1016/j.jiph.2022.01.005

Abstract

Background: The Ebola virus has started to infect humans from time to time since then and has led to several outbreaks. Due to urbanisation growth, invasion of forested areas, and close interaction with wildlife animals, the spread of the Ebola virus has caused the deadliest diseases to animals and humans. To date, the Ebola virus disease (EVD) claimed many lives of human beings and a greater number of cases were observed in the African region. Hence, a review was carried out to analyse the trends in EVD outbreaks, morbidity and mortality among EVD patients, efficacy and safety of drugs approved for the treatment of EVD.

Method: The literature on EVD outbreaks, safety, and efficacy of EVD drugs were searched on Science Direct, PubMed, and Google Scholar using the MeSH terms such as ̈Ebola, Ebola virus disease, Outbreak, Epidemic, Safety, Efficacy, for the period of 2016-2020. In addition to that. Centers for Disease Control & Prevention (CDC), World Health Organization (WHO), US Food & Drug Administration, and UpToDate websites also searched for the latest reports, guidelines, approved drugs, etc. RESULTS: There are only a few treatment options available for EVD to date, the most commonly used drugs for EVD are ZMapp, Inmazeb, and Ebanga. The review found that among these three drugs, ZMapp Plus is superior in the treatment of EVD with the current standard of care of 91.2%. INMAZEB when given at a 3 ml/kg IV dose reduced the mortality rate by 17% in subjects with EVD. Ebanga has shown a mortality rate of 35.1% when given a 50 mg/kg single IV dose. The most observed adverse effects were fever, tachycardia, diarrhoea, vomiting, hypotension, tachypnea, and chills.

Conclusion: Overall, Inmazeb is the preferred drug of choice over ZMapp or other drugs for the treatment of EVD, and Ebanga is a choice in patients with cardiovascular complications. In addition to that, supportive care is very essential to control the mortality rate.

Keywords: Africa; Epidemic; Haemorrhagic fever; Infection; Monoclonal antibody; Tropical disease.

Publication types

Review
Systematic Review

MeSH terms

Animals
Antibodies, Monoclonal, Humanized
Disease Outbreaks
Drug Combinations
Hemorrhagic Fever, Ebola* / drug therapy
Hemorrhagic Fever, Ebola* / epidemiology
Hemorrhagic Fever, Ebola* / prevention & control
Humans
United States / epidemiology
United States Food and Drug Administration

Substances

Antibodies, Monoclonal, Humanized
Drug Combinations
atoltivimab, maftivimab, and odesivimab-ebgn drug combination
ansuvimab