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Therapeutics for Nipah virus disease: a systematic review to support prioritisation of drug candidates for clinical trials

Chan XHS 1 , Haeusler IL 2 , Choy BJK 2 , Hassan MZ 3 , Takata J 4 , Hurst TP 2 Show all authors , Jones LM 5 , Loganathan S 6 , Harriss E 7 , Dunning J 8 , Tarning J 9 , Carroll MW 5 , Horby PW 10 , Olliaro PL 10

Affiliations 

  • 1 Pandemic Sciences Institute Nuffield Department of Medicine, University of Oxford, Oxford, UK; Centre for Tropical Medicine and Global Health Nuffield Department of Medicine, University of Oxford, Oxford, UK; Department of Clinical Infection, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Electronic address: xin-hui.chan@ndm.ox.ac.uk
  • 2 Pandemic Sciences Institute Nuffield Department of Medicine, University of Oxford, Oxford, UK
  • 3 Pandemic Sciences Institute Nuffield Department of Medicine, University of Oxford, Oxford, UK; International Severe Acute Respiratory and Emerging Infection Consortium University of Oxford, Oxford, UK; Programme for Emerging Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
  • 4 Department of Clinical Infection, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  • 5 Pandemic Sciences Institute Nuffield Department of Medicine, University of Oxford, Oxford, UK; Centre for Human Genetics Nuffield Department of Medicine, University of Oxford, Oxford, UK
  • 6 Academic Foundation Programme, Kent Surrey and Sussex Deanery, London, UK
  • 7 Bodleian Health Care Libraries University of Oxford, Oxford, UK
  • 8 Pandemic Sciences Institute Nuffield Department of Medicine, University of Oxford, Oxford, UK; International Severe Acute Respiratory and Emerging Infection Consortium University of Oxford, Oxford, UK; Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, UK
  • 9 Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health Nuffield Department of Medicine, University of Oxford, Oxford, UK
  • 10 Pandemic Sciences Institute Nuffield Department of Medicine, University of Oxford, Oxford, UK; International Severe Acute Respiratory and Emerging Infection Consortium University of Oxford, Oxford, UK
Lancet Microbe, 2024 Nov 12.
PMID: 39549708 DOI: 10.1016/j.lanmic.2024.101002

Abstract

Nipah virus disease is a bat-borne zoonosis with person-to-person transmission, a case-fatality rate of 38-75%, and well recognised potential to cause a pandemic. The first reported outbreak of Nipah virus disease occurred in Malaysia and Singapore in 1998, which has since been followed by multiple outbreaks in Bangladesh and India. To date, no therapeutics or vaccines have been approved to treat Nipah virus disease, and only few such candidates are in development. In this Review, we aim to assess the safety and efficacy of the therapeutic options (monoclonal antibodies and small molecules) for Nipah virus disease and other henipaviral diseases to support prioritisation of drug candidates for further evaluation in clinical trials. At present, sufficient evidence exists to suggest trialling 1F5, m102.4, and remdesivir (alone or in combination) for prophylaxis and early treatment of Nipah virus disease. In addition to well designed clinical efficacy trials, in-vivo pharmacokinetic-pharmacodynamic studies are needed to optimise the selection and dosing of therapeutic candidates in animal challenge and natural human infection.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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