The oral drug obeldesivir protects nonhuman primates against lethal Ebola virus infection
Courtney Woolsey, Robert W. Cross, Victor C. Chu, Abhishek N. Prasad, Krystle N. Agans, Viktoriya Borisevich, Daniel J. Deer, Mack B. Harrison, Jasmine Martinez, Natalie S. Dobias, Karla A. Fenton, Tomáš Cihlář, Anh-Quan Nguyen, Darius Babusis, Roy Bannister, Meghan S. Vermillion, Thomas W. Geisbert
Abstract
Obeldesivir (ODV; GS-5245) is an orally administered ester prodrug of the parent nucleoside GS-441524 that has broad spectrum antiviral activity inhibiting viral RNA-dependent RNA polymerases. We recently showed that ODV completely protects cynomolgus macaques against lethal infection with Sudan virus when given 24 hours after parenteral exposure. Here, we report that once daily oral ODV treatment of cynomolgus and rhesus macaques for 10 days confers 80 and 100% protection, respectively, against lethal Ebola virus infection when treatment is initiated 24 hours after mucosal (conjunctival) exposure. ODV treatment delayed viral replication to abate excessive inflammation and promote adaptive immunity. For outbreak response, oral antivirals might present substantial advantages over now approved intravenous drugs, such as easy supply, storage, distribution, and administration. Furthermore, these results support the potential of ODV as an oral postexposure prophylaxis with broad spectrum activity across filoviruses.