Tekmira's Failed Ebola Trial: The Value of Real-time Research

It is significant that the trial of TKM-Ebola, Tekmira's anti-Ebola antiviral was halted for futility (as it did not appear to improve clinical outcome). Such a result is disappointing but underscores the importance of clinical trials of compounds that, albeit promising results in non-human primates, have not been used in human infections. 

During the height of the Ebola media blitz I was often asked about how these antivirals should be used and whether trials should even be pursued because blanket administration is the "right thing" to do. I strongly pointed out that such a blind approach is fraught with problems such as obtaining informed consent and controlling for extraneous variables that may muddle the treatment effect, often invoking comparisons to the Tuskegee syphilis study (which lacked informed consent) and the events depicted in the movie The Constant Gardner.

Clinical trials of medications and interventions against Ebola are ongoing and just because one product did not work doesn't mean others won't. Determining the benefit of ZMapp, brincidofivir, favipiravir, vaccination, as well as aggressive intravenous fluid resuscitation and electrolyte management (where I think the real benefit will be found) remain important tasks ahead. 

The unfortunate results of this trial are just as important for clinical management as they are for research standards, which are crucial to adhere to even in infectious disease emergencies.