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Filoviruses frequently emerge to cause terrifying outbreaks of often-fatal human disease. Treatment options so far have focused on monoclonal antibodies. Remdesivir is an adenosine analog that binds viral RNA polymerase to block replication by premature termination of RNA transcription. The drug has been successfully used intravenously for treating progressive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in humans. Cross et al. tested a related oral prodrug, obeldesivir (currently in phase 3 clinical trials for COVID-19 treatment), in nonhuman primates for its therapeutic value against filoviruses (see the Perspective by Sprecher and Van Herp). When administered to the animals within 24 hours of virus exposure once daily for 10 days, the drug conferred complete protection against lethal infection with Sudan ebolavirus. Having an oral drug would be a major logistical advantage for use in the remote, resource-poor areas where filoviruses occur. —Caroline Ash
Published in Science (March 15, 2024):
