Key facts
- US measles cases have hit a 35-year high, surpassing 2,289 cases by July.
- Vaccination rates have fallen below the 95% threshold needed for herd immunity.
- Invivyd is developing a monoclonal antibody therapy, similar to those used for COVID-19.
- Researchers have identified human antibodies capable of blocking measles infection.
- An oral antiviral drug has shown promise in animal models.
- Development faces challenges including high costs, complex manufacturing, and uncertain patient acceptance.
The United States is experiencing a significant resurgence of measles cases, reaching a 35-year high, prompting biotech firms and academic researchers to accelerate the development of new treatments. Declining vaccination rates, falling below the 95% threshold required for herd immunity, have created a public health challenge, leaving vulnerable populations like infants and immunocompromised individuals at increased risk.
Currently, medical professionals rely on supportive care for measles patients, as there is no specific antiviral treatment. This includes managing symptoms like dehydration and breathing difficulties, and administering steroids for inflammation. Vitamin A is sometimes given, but it does not directly combat the virus. Michael Mina, an epidemiologist and chief medical officer at Invivyd, highlighted the "horrible lack of options" for those exposed to the virus.
Several promising avenues are being explored. Invivyd is developing a monoclonal antibody therapy, similar to those used for COVID-19, which could offer short-term protection to high-risk individuals. These antibodies mimic the body's natural defenses and can last for a few months. The company is preparing data for FDA approval to begin clinical trials. Researchers at the La Jolla Institute for Immunology have identified human antibodies that effectively block measles infection in laboratory studies, showing a significant reduction in viral load in rodents. Vanderbilt University scientists, known for their work on COVID-19 antibodies, have also discovered potent measles antibodies and are partnering with Saravir Biopharma for further development. James Crowe, an immunologist at Vanderbilt, aims to use a combination of two monoclonal antibodies to prevent the virus from mutating and evading treatment.
Antiviral drugs are also under investigation. Researchers at Georgia State University have identified an oral antiviral that demonstrated success in lowering viral load and ensuring survival in animal models, though it has not yet been tested in humans. A key challenge for antivirals is their potential toxicity and side effects.
Despite these advancements, significant hurdles remain. The development and large-scale manufacturing of monoclonal antibodies are costly and complex, often requiring pharmaceutical partnerships for funding. Drugs for infectious diseases are typically not lucrative due to the sporadic nature of outbreaks and short treatment durations, making measles treatments a potentially difficult sell for pharmaceutical companies. Furthermore, the cost of these treatments, even if free to patients, can still result in substantial out-of-pocket expenses for administration. Regulators also face the challenge of evaluating these new drugs, particularly for pediatric use, as measles complications are more severe in children.
A major question is whether individuals who refuse vaccines will accept these new treatments. Mina expressed hope that monoclonal antibodies might be more readily accepted because they mimic natural bodily molecules. However, past instances, such as parents refusing immune globulin during a Utah measles outbreak, suggest potential resistance rooted in anti-science sentiment.