As governments and health authorities scramble to respond to the worsening Ebola outbreak in central Africa, Merck & Co. is considering discontinuing its antiviral drug molnupiravir, which was expected to be used to treat COVID-19 under emergency use authorization during the pandemic.
Eliav Barr, M.D., chief medical officer at Merck Research Laboratories, told Reuters at the ASCO conference in Chicago over the weekend that the New Jersey drug giant is currently in discussions with multiple global health authorities about making the pill, also known as Lagebryo, available as a treatment for Ebola.
“Molnupiravir is a non-specific RNA virus drug,” Barr told the publication. “We’re looking at how we can take advantage of that,” he said, adding that Merck is “in a lot of discussions with various parties about this.”
“Merck has a long history of responding to disease outbreaks and remains committed to public health and vaccine innovation,” a company spokesperson told Fiers in an emailed statement confirming the strategy.
“We are considering how we can support response efforts to the Bundibugyo Ebola outbreak in the Democratic Republic of the Congo and Uganda,” he added, “including potential collaboration with global health and research institutions on treatment and prevention research and vaccine development.”
Importantly, “Although molnupiravir has antiviral activity in preclinical in vitro studies against a variety of viruses, including Ebola and Sudan, there are currently no data to support the use of molnupiravir for the treatment or prevention of Ebola-Bundibugyo virus,” the spokesperson said.
However, based on the drug’s mechanism of action, it may have activity against other Ebola virus strains, and Merck said it is currently “in vitro studies underway to evaluate this for the Bundibugyo strain.”
The spokesperson noted that molnupiravir is not used or recommended in response to current or past Ebola outbreaks, but “we have available stock” if recommended or needed.
In an interview with Reuters, Barr said Merck is also looking into whether the technology behind the existing Ebola virus vaccine Elvevo, used to prevent a more common variant of the virus, could be used to develop new vaccines against the current outbreak.
According to the World Health Organization (WHO), the Bundibugyo virus, which is responsible for the current Ebola outbreaks in the Democratic Republic of the Congo and Uganda, has resulted in approximately 906 suspected cases and 223 suspected deaths in the first countries, and as of May 29, there have been a total of 134 confirmed cases overall, including nine in Uganda.
Organizations and pharmaceutical companies alike are scouring the clinical and commercial arsenal for potential tools against Ebola as cases continue to rise and healthcare workers struggle to combat the virus.
In May, the U.S. Department of Health and Human Services (HHS) confirmed to Fierce that it was working with a small biotech called Map Biopharmaceutical to access doses of experimental antibodies for potential use against Ebola in high-risk individuals.
The antibody was developed in collaboration with the Biomedical Advanced Research and Development Authority against Sudan virus, a type of Ebola virus distinct from the Bundibugyo species.
The asset, coded MBP134, has also shown potential against Bundibugyo in laboratory studies, an HHS spokesperson said last month, adding that the potential use of the treatment would be coordinated by the FDA, the State Department, and the Office of Strategic Preparedness and Response in a “whole-of-government approach.”
The WHO has also singled out Map’s drug, along with antiviral treatments from Regeneron and Gilead Sciences, as prime candidates for testing in patients infected with the Bundibugyo Ebola virus, news outlets including Pharmaforum and Stat News reported.
Other companies, like RedHill Biopharma, are also trying to take on the challenge. The Tel Aviv-based company announced Tuesday that it is in discussions about a potential collaboration to advance the development of opaganib, an investigational oral drug against the Bundibugyo Ebola virus subtype.
Red Hill is leveraging data from adding its SPHK2 inhibitor to Gilead’s remdesivir and corticosteroids in late-stage severe coronavirus disease (COVID-19) trials in the bid.
On the prevention front, the Coalition for Epidemic Preparedness Innovations (CEPI) announced on Monday that it would “urgently accelerate” the development of three investigational vaccines against the Bundibugyo Ebola virus developed by IAVI, Moderna and the University of Oxford in partnership with the Serum Institute of India, the world’s largest vaccine maker. CEPI said it is looking for additional candidates beyond the initial three.
Meanwhile, Merck’s molnupiravir, which first gained attention during the coronavirus pandemic, received emergency approval (PDF) to treat mild to moderate COVID-19 in certain adults at high risk of progressing to severe coronavirus disease.
The drug subsequently failed to receive full FDA consent, and Merck and its Radebrio partner Ridgeback Biotherapeutics withdrew their bid to approve the antiviral drug’s coronavirus marketing in the European Union in 2023.
Editor’s note: This article has been updated with a statement from Merck & Co.
