Challenges in the Clinical Development of a Monoclonal Antibody against Chikungunya Virus
Hugh Watson, PhD
Evotec ID (Lyon), Lyon, France
Chikungunya virus has spread widely through tropical regions of the world in the last 15 years, giving rise to chronic and disabling rheumatic symptoms in a significant proportion of patients. A fully human monoclonal antibody against the viral E2 protein has been shown to be effective at preventing and suppressing viraemia in animal models. Clinical testing of an antibody in the unpredictable setting of chikungunya outbreaks will meet a number of challenges. These include the rapid implementation of trials, reliable diagnosis of patients, the therapeutic window for treatment, and the identification of patients at highest risk of chronic symptoms. Subsequently, improvement will have to be demonstrated in meaningful patient outcomes or in objective surrogate endpoints which have still to be defined. The many clinical similarities between rheumatoid arthritis and chronic chikungunya suggest that clinical trial endpoints validated for rheumatoid arthritis will be a good starting point. The validation of these endpoints and potential clinical trial designs in chikungunya will be reviewed. A potent anti-CHIKV mAb is a good start, but the success of future clinical trials is not assured.
The International Society for Antiviral Research (ISAR) is an internationally recognized organization for scientists involved in basic, applied, and clinical aspects of antiviral research. The Society main event is the annual International Conference on Antiviral Research (ICAR), a truly interdisciplinary meeting which attracts the interest of chemists, biologists, and clinicians.