Current updates on the epidemiology, pathogenesis and development of small molecule therapeutics for the treatment of Ebola virus infections

Ebola virus disease (EVD) is a rare, highly contagious and a deadly disease with a variable fatality rate ranging from 30% to 90%. Over the past two decades, Ebola pandemic has severely affected the sub-Sahara region including Democratic Republic of the Congo (DRC), and Uganda. The causative agents of the most EVD cases are three distinct species out of six Ebolaviruses namely Zaire Ebolavirus (ZEBOV), Sudan Ebolavirus (SUDV) and Bundibugyo Ebolavirus (BDBV). In recent years, significant strides have been made in therapeutic interventions. Notably, the US Food and Drug Administration has approved two monoclonal antibodies: InmazebTM (REGN-EB3) and Ansuvimab or Ebanga™. Additionally, many small molecules are currently in the developmental stage, promising further progress in medical treatment. Addressing the critical need for preventive measures, this review provides an in-depth analysis of the licensed Ebola vaccines-Ervebo and the combination of Zabdeno (Ad26.ZEBOV) and Mvabea (MVA-BN-Filo) as well as the vaccines which are currently being tested for their efficacy and safety in clinical studies. These vaccines might play an important role in curbing the spread and mitigating the impact of this lethal disease. The current treatment landscape for EVD encompasses both nutritional (supportive) and drug therapies. The review comprehensively details the origin, pathogenesis, and epidemiology of EVD, shedding light on the ongoing efforts to combat this devastating disease. It explores small molecules in various stages of the development, discusses patents filed or granted, and delves into the clinical and supportive therapies that form the cornerstone of EVD management. This review aims to provide the recent developments made in the design and synthesis of small molecules for scientific community to facilitate a deeper understanding of the disease and fostering the development of effective strategies for prevention, treatment, and control of EVD.