German doctors think they have another possible drug to add to the Ebola treatment pipeline. It’s one already shown to be safe and in trials to treat heart attack victims.
The drug, called FX06, is made using a natural human blood-clotting protein called fibrin. The hope is it can help reduce the leaking of blood vessels that can seriously threaten people with advanced Ebola infections.
The team at Frankfurt University Hospital say it may have helped save a Ugandan doctor they treated, although they note it failed to save a second patient.
Nonetheless, it should be tested, they wrote in the Lancet medical journal.
“Even though the patient was critically ill, we were able to support him long enough for his body to start antibody production and for the virus to be cleared by his body’s defenses,” said Dr. Timo Wolf, who helped lead the research team. "FX06 could potentially be a valuable agent in contribution to supportive therapy."
It would join about a half dozen drugs being tested against Ebola, none of which has yet been shown to help patients recover. They include the antibody-based drug ZMapp, another drug made by Canadian pharmaceutical company Tekmira, a drug called brincidofovir, made by North Carolina-based Chimerix and another drug made by North Carolina based BioCryst called BCX4430. A Japanese flu drug called favipiravir is also being tested.
Serum from people who have survived Ebola is another approach that’s been tried. Doctors say it’s impossible to know what really works without trials in large numbers of people, because one patient may recover for reasons unrelated to any one specific treatment. Separately, several vaccines are being tested, too.
The Ugandan doctor was airlifted to Frankfurt after becoming infected while working in Sierra Leone. He was already extremely ill, with multiple organ failure.
He had already been treating himself, and that included taking a heart rhythm drug called amiodarone, which some doctors believe may help work against viruses like Ebola. The Italian aid group Emergency plans to test the drug in Ebola patients in Sierra Leone.
When the 38-year-old doctor arrived in Frankfurt he was given antibiotics right away to prevent any other infections and was also put on dialysis because his kidneys were failing.
The medical team tried every possible treatment. “Because the patient’s pulmonary vascular leak syndrome was worsening, the ethics committee of Frankfurt University Hospital approved the use of a fibrin-derived peptide … FX06, which is under clinical development for vascular leak syndrome, in the attempt to prevent further leakage,” Wolf’s team wrote.
"We feel that FX06 warrants further evaluation in the treatment of vascular leak syndrome in Ebola virus disease."
They also tried favipiravir but the patient couldn’t hold down the pills. And they tried a blood filter made by a San Diego company called Aethlon.
It’s impossible to know which treatments helped. Like other patients who got experimental drugs, the Ugandan doctor, who asked not to be named, got the very best supportive medical care. He was on a ventilator to help him breathe, had constant fluid replacement and got minerals called electrolytes to replace those lost to vomiting and diarrhea.
By the 22nd day, he could breathe on his own again and the virus was gone from his blood three days before that.
“On the basis of our experience, we feel that FX06 warrants further evaluation in the treatment of vascular leak syndrome in Ebola virus disease,” Wolf’s team wrote.
Most experts treating Ebola patients in Africa say they worry that a focus on drugs and vaccines will distract from the more important mission of isolating patients, giving them supportive care, and preventing the further spread of the virus. They do not believe drugs will be a widespread or useful tool for fighting Ebola any time soon.
Nonetheless, the U.S. National Institutes of Health has sped up funding for research into Ebola drugs and vaccines, and Congress, in its latest budget, has ordered NIH to continue doing so.