A dose of reality

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Science  21 Nov 2014:
Vol. 346, Issue 6212, pp. 908-911
DOI: 10.1126/science.346.6212.908


A few dozen people with Ebola have received experimental treatments like the now-famous antibody cocktail called ZMapp, but no one has any idea whether the interventions helped, hurt, or did nothing. Not only did the patients receive several treatments at once, including intensive supportive care, but also no control group existed to compare their fate. Next month, three potential treatments against Ebola will receive the first real-world tests in organized clinical trials. The first interventions to be tested are not the ones that had the most promising results in animal models, but rather are those most readily available: convalescent serum from people who had Ebola and recovered, an influenza drug on the market in Japan, and an experimental drug already in efficacy trials for other viral diseases. Intense debates have centered on the design of the trials, which, for ethical reasons, opted not to use the traditional control scheme of randomly assigning only some of the participants to receive the intervention. But other randomized controlled trials are in the works and should start soon, too.

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