Study leader Anna Durbin discusses the power and limits of a provocative human challenge trial
Asking people to get injected with a debilitating virus, even a weakened version of it, is a tall order—but it’s also a powerful and fast way to test an experimental antiviral in a small study.
The study, jointly funded the company and the U.S. National Institutes of Health, is the first human trial of a dengue drug to show success, Van Loock says. Phase 1 studies earlier showed the drug was safe, and the company now has a placebo-controlled,that aims to enroll nearly 2000 people in 10 Latin American and Asian countries. Results are expected by 2025.
Q: The challenge virus you used is serotype 3. Would the drug work against the other three dengue serotypes? The drug is specific to all four serotypes of dengue. Our challenge virus is less sensitive to the drug than the other three serotypes. So we thought this is a more stringent test, because if it works against this, it should work against the others. One of the reasons this strain was chosen as a vaccine candidate is because it doesn’t replicate well in mosquitoes.
Q: Do you think that injecting someone with a virus provides a higher or lower dose than a mosquito infecting them? We know that mosquito saliva has some factors in it, anticoagulants and things like that, that may or may not improve the infectivity. It’s an important question. I’m so used to it now. To me, it’s like giving a vaccine. They get $125 for each outpatient visit, and total compensation over 3 months was between $2000 and $3000. It might work as a prophylactic for certain settings.
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