Issue: May 2019
March 29, 2019
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Survival times improved in favipiravir-treated Ebola patients

Issue: May 2019
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Treatment with favipiravir, an experimental antiviral, improved the survival time of patients with Ebola virus disease during the West African epidemic, study findings showed.

Favipiravir (Toyama) was one of several investigational therapies tested during the epidemic, which infected more than 28,000 people and killed over 11,300, mostly in Guinea, Liberia and Sierra Leone. It is currently being evaluated again in a pioneering multidrug trial during the current Ebola outbreak in the Democratic Republic of the Congo.

In a retrospective study, Romy Kerber, PhD, a scientist in the department of virology at the Bernhard Nocht Institute for Tropical Medicine, and colleagues assessed the outcomes of 163 patients diagnosed with Ebola virus disease in 2015 in Guinea, including 73 who were treated with favipiravir.

Results showed that the case fatality rate in favipiravir-treated patients was lower than that in untreated patients — 42.5% and 57.8%, respectively. Kerber and colleagues said the findings revealed “a trend toward improved survivability” among patients treated with favipiravir, though they found that the effect was not statistically significant.

According to the study, in the multivariate regression analysis, higher cycle threshold (Ct) value and younger age were associated with survival (P < 0.001) and favipiravir treatment showed no significant effect (P = 0.11). However, an analysis of survival time revealed a statistically significant difference that indicated prolonged survival in the favipiravir-treated group (P = 0.015).

Kerber and colleagues said the findings were consistent with those from the JIKI trial, which indicated that favipiravir may reduce mortality rates among patients with Ebola virus and lower viral loads.

“Pharmacokinetics data in [Ebola virus disease] patients enrolled in the JIKI trial revealed drug concentrations lower than targeted. Therefore, it is conceivable that administrating higher doses of favipiravir, increasing its bioavailability, or modulating its metabolism could enhance its therapeutic effect,” Kerber and colleagues wrote. “In conclusion, the observations made so far with favipiravir including those presented here call for further preclinical and clinical studies to better understand pharmacokinetics, pharmacodynamics, and adverse events at various dosing schemes and application forms.” – by Caitlyn Stulpin

Disclosures: The authors report no relevant financial disclosures.