Brussels, 07/01/2016 (Agence Europe) - The treatment of Ebola patients by using blood plasma from people cured of Ebola is possible. It does not present any risks and is acceptable to donors, patients and health professionals. Nonetheless, the treatment, as administered in a clinical trial, does not significantly improve the chances of a patient's survival.
These are the disappointing results from the Ebola-Tx clinical trial published on Thursday 7 January in the New England Journal of Medicine. Nonetheless, researchers believe that there is still hope.
Johan van Griensven from the Institute of Tropical Medicine (IMT) in Antwerp was in charge of coordinating the trial and explained “a single dose of two plasma units from recovering patients does not save lives but subsequent analyses could reveal that the quantity of antibodies in the donor's plasma could have had an impact on the results of the treatment. Perhaps more targeted use and concentrated plasma could help patients fight the virus”.
The level of antibodies neutralising the Ebola virus in the donor's plasma used during the trial cannot not seen as being decisive when administering treatment, due to the lack of available trials on the ground to measure these antibodies. Samples have been sent for analysis in France and researchers are hoping to present additional results in the next few months to decide whether plasma containing high levels of antibodies is more efficient.
This was the most extensive clinical trial ever carried out to tackle the infection using convalescent patients' plasma and was carried out by the Institute of Tropical Medicine in Antwerp between February and July 2015 at the Donka Ebola Treatment Centre, managed by the MSF in Conakry, Guinea. They received funding from the Horizon 2020 EU Research and Innovation Framework Programme, to the tune of €2.9 million, allocated in October 2014 to a research consortium.
Dr Ruxandra Draghia-Akli, director of the European Commission's Directorate General Health, said in a press release that “these results provide the response to a significant lack of knowledge about the Ebola virus, as well as additional elements to EU funded projects”. She is encouraging specialist journals to promote the publication of this kind of conclusions, “even if the treatment turns out to be inefficient in the treatment of the Ebola virus”.
Although many Ebola infected patients could not be saved, despite health care support in Ebola treatment centres, it was very important for MSF to identify what treatments could be directly targeted towards the virus.
The Ebola Tx clinical trial involved 102 patients of all ages, each receiving between 200-250 ml of plasma from different convalescent donors in the 48 hours following confirmation of the Ebola diagnosis by the laboratory. The patients attending the same treatment centre over five months preceding the study were used as the reference group of 102 patients. 84 patients treated with plasma from convalescent patients and 418 reference group patients were included in the analysis. The first criteria involved surviving 14 days after transfusion. A mortality rate less than 20% in the group treated with plasma from convalescent patients was considered as a clinically significant difference. Moreover, the difference in mortality between the reference group and the one receiving the treatment, after age adjustments and viral loads, was only 2.6%.
It should be pointed out that under the Horizon 2020 research and innovation programme, the EU also funded the clinical trial into the anti-viral favipiravir medicine also used to treat patients suffering from the Ebola virus (see EUROPE 11261). (Original version in French by Aminata Niang)