Two monoclonal antibody products have FDA approval against Zaire ebolavirus disease. No approved therapeutic targets Sudan, Bundibugyo, or other strains.
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What is the treatment for Ebola?
Two monoclonal antibody therapies are FDA-approved, but only for Zaire ebolavirus. No approved therapeutic targets Bundibugyo.
For Zaire ebolavirus disease, the standard of care is one of two
FDA-approved monoclonal antibody products,
Inmazeb (Regeneron's
atoltivimab + maftivimab + odesivimab, approved October 2020) or
Ebanga (Ridgeback's
ansuvimab, approved December 2020), combined with aggressive supportive
care. Both products were validated in the 2018-2019 PALM trial in DRC,
where they reduced 28-day mortality versus controls. For the 2026
Bundibugyo PHEIC, neither product is indicated. Supportive care, fluid
and electrolyte management, and treatment of co-infections remain the
only proven interventions for BDBV, SUDV, and other non-Zaire strains.
Three-monoclonal-antibody cocktail directed against Zaire ebolavirus surface glycoprotein.
Administration
Single intravenous infusion.
Target strain
EBOV
FDA approval
2020
EMA approval
2020
Clinical evidence
PALM trial (DRC 2018–2019, NEJM 2019) demonstrated lower mortality vs. ZMapp control (33% vs. 51% in the modified intent-to-treat analysis). Mortality benefit largest among patients treated early with lower viral loads.
Nucleotide analog inhibitor of viral RNA-dependent RNA polymerase. Originally developed for Ebola; later repurposed for COVID-19.
Administration
Intravenous (historical use).
Target strain
EBOV
Clinical evidence
In the 2018–2019 PALM trial, remdesivir performed worse than the monoclonal antibody arms and is no longer recommended for Ebola virus disease. Listed here only for completeness; current Ebola standard of care is monoclonal antibodies + supportive care.
Aggressive supportive care has independently improved Ebola
survival across outbreaks. The core elements: intravenous fluid
resuscitation, electrolyte replacement (potassium, calcium,
magnesium losses through diarrhoea and vomiting), nutritional
support, empirical antimalarial and antibacterial treatment for
common co-infections, and management of complications such as
acute kidney injury and disseminated intravascular coagulation.
These interventions are strain-agnostic: they are the standard of
care for any ebolavirus species, whether or not an approved
monoclonal antibody is available.
