WHO In Race To Find Promising Ebola Treatments As Many Products Ruled Out

Proposals for products to help fight Ebola are coming in to the World Health Organization, but few look promising so far, an official said today. Meanwhile, efforts are on to establish testing sites for potential products, and thinking is still in the early stages on intellectual property rights for new drugs in development.

A WHO technical advisory committee on Ebola met this week to discuss potential therapeutic interventions for Ebola, and reviewed therapeutic drugs and blood products. Although not discussed during the meeting, a WHO official restated earlier declarations that intellectual property rights are not yet being addressed.

The meeting of the WHO Scientific and Technical Advisory Committee on Ebola Experimental Interventions (STAC-EE) met on 11-12 November.

According to the WHO, the meeting was attended by experts in Ebola virus, preclinical and clinical testing, pharmacologists, sociologists, public health experts and regulators, as well as representatives from countries in West Africa.

During a press briefing today, Martin Friede of the WHO Public Health, Innovation and Intellectual Property Division said the focus of the meeting was therapeutic drugs and blood products.

Among the centres in West Africa providing Ebola care, very few have a continuous standard of care over time, the capacity and infrastructure to take on clinical trials for new drugs, he said. The committee determined that “only a handful of sites” would be suitable for trials, while some 120 product proposals have reached WHO.

Among products being evaluated are convalescent blood and new drugs. There is not much evidence that convalescent blood is efficacious, he said, which calls for clinical trials.

One of the first challenges is to increase capacity in West Africa, he said, particularly the infrastructure so that clinical trials of convalescent blood be conducted. Clinical trials are expected to start in West Africa in coming weeks, he said.

Many Candidate Drugs, Most Proved Ineffective

Out of the some 120 propositions for products received by WHO to treat Ebola, “many have already been tested and shown to be negative,” he said.

There is a need to “get in the public domain” a regularly updated database to show what is being tested and what does not work, he said.

A WHO briefing note states that the committee “agreed that these products, excluded from clinical trials at this stage, will be published on the WHO web site to enable scientists and developers to assess themselves whether further investigation is warranted.”

Several drugs show good results in trials on monkeys, according to the briefing note, but most of those products are in early stages of development and the process for manufacturing scale-up has not yet been developed. The available supply is extremely limited and large clinical trials would be almost impossible, Friede said.

Other products would be easier to make, according to the note, or already approved for other purposes, but according to Friede, supporting data is “rather weak” and requires additional clinical studies. Several products are in that group, he said, including: favipiravir, brincidofivir, toremifine, and interferons, which were reviewed by the committee.

Some clinical trials on these drugs are planned in the coming weeks. “We do not have a lot of drugs in our pipeline which look promising,” he added.

WHO has established a working group to review drugs and find supportive data, he said, with a set of criteria that has been approved by the technical advisory committee, which will allow the WHO to decide if a drug is ready to go into clinical trials, or if additional studies are needed.

IP a Potential Issue for Drugs in Development

Although not discussed by the committee this week, Friede said intellectual property is not presenting a barrier for potential treatments for the moment.

For the drugs currently available “that can be simply procured,” IP is “not at all an issue,” he said. For the vaccines, there are already eight or nine companies developing those vaccines and IP is not an issue.

For the drugs under development, “it is possible that IP is an issue,” he said, but since they are under development and have not been approved, for the moment IP is not perceived as a barrier to access, he said.

 

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