WHO Trial to Test Two Drugs Against Bundibugyo Ebola
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- World Health Organization officials announced a clinical trial set to begin next week in the Democratic Republic of the Congo testing Gilead Sciences' antiviral remdesivir and MappBio's monoclonal antibody MBP-134, both individually and in combination, against the Bundibugyo ebolavirus.
- The DRC outbreak has reached 1,118 confirmed cases with 291 deaths as of Tuesday, making it the third largest Ebola outbreak on record; neighboring Uganda has recorded 20 confirmed cases and two deaths from imported cases with limited local spread.
- The U.S. government supplied doses of MBP-134 for the trial and funded prior research on the monoclonal through the Biomedical Advanced Research and Development Authority, while Gilead provided doses of remdesivir.
- The four-arm trial will randomly assign participants to receive MBP-134 alone, remdesivir alone, both therapeutics, or supportive care, with enrollment handled by NGOs including ALIMA, Doctors Without Borders, and Samaritan's Purse operating Ebola treatment units.
- Vasee Moorthy, acting lead of WHO's R&D Blueprint group, said the trial will need approximately 1,000 participants because the Bundibugyo species appears to trigger less severe disease — meaning more people must be enrolled before a statistically meaningful safety and efficacy answer is possible.
- No drugs or vaccines have been proved effective against the Bundibugyo species, and this is only the third known outbreak involving the strain, which was first detected in 2007.
Why it matters: The trial addresses a drug-and-vaccine vacuum: no therapeutics have been proved effective against the Bundibugyo species, which has driven 1,118 cases and 291 deaths in DRC plus imported spread into Uganda. The need for ~1,000 participants — inflated by the strain's apparently lower fatality rate — and the outbreak's location in a politically unstable, food-insecure zone with mass displacement make the logistics as challenging as the science.
