Measles has become so common that treatments may soon be needed

“I think this is a real opportunity to solve a public health problem,” Safire says. “A tool with which you can prevent or treat disease is still cheaper than managing an outbreak or managing a case of fatal encephalitis in a child.” Some disease models predict this Measles can become endemic in the United States in the next 25 years, even at current state-level vaccination rates.

Monoclonal antibodies can also be expensive for patients and insurance companies. In early 2022, the US government spent $855 million For 1.7 million doses of Evushheld, an approved monoclonal antibody treatment for Covid. The drug itself was free to patients, but some people received hundreds of dollars Out of pocket costs Related to medication management.

The monoclonal antibody cocktail that became Evusheld was created in just 25 days by scientists at Vanderbilt University, who also discovered powerful antibodies to measles. The university has partnered with small biotech company Saravir Biopharma for further development.

The strategy is to use a combination of two monoclonal antibodies to significantly reduce the chances of the measles virus mutating to avoid it, says James Crowe, an immunologist and director of the Vanderbilt Center for Antibody Therapeutics who has led the Covid work. His group has been systematically working to create human antibodies against viruses most likely to cause future pandemics, and happened to be in the middle of working on measles last year when measles cases spiked in the United States.

“The antibodies we isolated are very powerful, they strongly inhibit the virus,” says Crowe. “We are confident that they can be formulated as a long-acting single dose.”

Once these monoclonal antibodies are ready for human testing, regulators will need to figure out how to evaluate them in clinical trials. New medicines are usually tested in adults first to make sure they are safe for children. But complications from measles are more likely to land children in the hospital, especially those who have not been vaccinated.

Antiviral medications can also be used as a strategy to treat measles, although they tend to be short-lived and must often be given very soon after a person becomes infected or starts showing symptoms to be effective. Researchers at Georgia State University identified an oral antiviral drug and tested it in mice, ferrets and dogs infected with related viruses in the orthoparamyxovirus family since these animals do not become infected with human measles. The drug reduced the viral load and all treated animals survived. It has not yet been tested on humans.

One challenge in developing antivirals is that drugs that are toxic enough to kill viruses often have unpleasant side effects in people.

But the big question is whether people will use the treatments being developed or allow their children to take them. While anti-vaccine sentiment is driving the current outbreak, Invivyd’s Mina hopes that people who haven’t vaccinated their children or gotten the vaccine themselves will be open to getting a monoclonal antibody because “this is a molecule that our bodies naturally make.”

But during a measles outbreak in Utah, some parents They refused To allow doctors to give their children immunoglobulin, a broad mixture of antibodies derived from donated plasma. Anti-science sentiment became more common with the leadership of Robert F. Kennedy Jr. to the Department of Health and Human Services, where he cast doubt on vaccines, depression treatments, and other established medical treatments.

This doesn’t mean that researching antibodies and other treatments for measles isn’t worth the effort, especially given the potential to help populations unable to be vaccinated. Crowe says it’s important to fund work on measles treatments as vaccination rates continue to decline.

“I think there will be hundreds of thousands of cases,” he says. “People are going to die. There is some urgency to finish this work.”