Drug trails in Guinea of a new ebola drug suggest that it might have some positive effect on mortality.
A researcher who had seen the data and asked not to be identified told Science that favipiravir did not help all of the patients treated with it at two trial sites in Guinea. In a subset of trial participants who had low levels of Ebola virus in the blood, however, the mortality was just 15%. In similar patients who entered the centers earlier and did not receive favipiravir, mortality was 30%.
The trials with this drug are being conducted without a control group, which makes it harder to pin down the cause of these results. The article also describes several other drugs being readied for testing, some of which are expected to be more effective.
The trials, however, are faced with two issues. First, the easing of the epidemic is making it more difficult to do the studies. And second,
So far, Guinea and Sierra Leone, where Ebola is still infecting dozens of people a week, have refused invitations to join the study. Their main stumbling block is trial design. ZMapp will be the first Ebola treatment that will be tested against a placebo control. “I think that’s the only way to tell whether these drugs are safe and effective,” Lane says. The governments of Guinea and Sierra Leone, as well as Doctors Without Borders, which runs Ebola centers in those countries, have for ethical reasons been reluctant to participate in treatment trials that use a placebo.
The moral dilemma of doing drug tests where some patients get a placebo has always been a problem for medical research. It is therefore not surprising to see it here as well.