ClinicalTrials.gg
Not yet recruitingNCT06841614EBO-PEPUpdated Jan 22, 2026

EBOla Post-Exposure Prophylaxis

A Phase 3 interventional study of Ervebo and Inmazeb in Ebola Virus Disease, sponsored by ANRS, Emerging Infectious Diseases. Not yet recruiting at 4 sites in 4 countries. Per ClinicalTrials.gov, last updated 2026-01-22.

Sponsored by ANRS, Emerging Infectious Diseases · Phase 3, Interventional, and Prevention

Phase
Phase 3
Study type
Interventional
Enrollment
160
Allocation
Randomized
Sex
All
01

Study summary

EBO-PEP is a multicentre, multi-epidemic, phase III, comparative, controlled, randomised, strict superiority trial in two unblinded parallel arms.

The trial will be open during EVD epidemics and will recruit asymptomatic participants at high risk of developing EVD.

Participants will be randomized (1:1) into one of two trial arms:

  • Arm 1 (ERV): Ervebo D0 (72 million PFU IM)
  • Arm 2 (ERV+IMZ): Ervebo D0 (72 million PFU IM) + Inmazeb IV (150 mg/kg) D0 + Ervebo D56 (revaccination)

Definition of high-risk:

Direct contact with a person with EBOV PCR-confirmed EVD with diarrhea, vomiting or external bleeding ("wet symptoms"), or with their body fluids; Direct contact with the dead body of a person with confirmed or probable EVD; Needlestick with a syringe contaminated by the blood of a person with confirmed or probable EVD; Or a child born to or breastfed by an individual with EVD

Trial follow-up All participants are monitored daily for a minimum of 21 days.

Some visits are conducted in person at the investigation site, also called the Post-Exposure Prophylaxis (PEP) center:

  • at Day 5, Day 10, and Day 21 for the ERV arm,
  • at Day 5, Day 10, Day 21, and Day 56 for the ERV+IMZ arm. Other visits are conducted at home or by phone, in collaboration with the Ministry of Health's surveillance team.

Participants in the ERV+IMZ arm have an in-person visit at Day 56 to be revaccinated with the Ervebo vaccine to compensate for potential inhibition of the vaccine response when Ervebo is administered simultaneously with Inmazeb.

Participants in the ERV arm have a phone visit at Day 56. For all participants, a phone visit is scheduled at Day 60. It corresponds to the last visit for all trial participants.

Follow-up in Case of Hospitalisation In case of clinical signs suggestive of EVD, participants enter the suspected case management pathway at the Ebola Treatment Center (ETC).

If EVD is confirmed by EBOV PCR, participants are allowed at the ETC, and their study samples are discontinued. They continue to be followed by the research team, and daily data are collected throughout their stay at the ETC until they are discharged alive or deceased. The day of discharge from the ETC marks the end of follow-up in the study for these participants.

Of note, participants in the ERV+IMZ arm who have confirmed EVD are not revaccinated at day 56.

Of note, participants in the ERV+IMZ arm who have confirmed EVD are not revaccinated at day 56.

If EVD is not confirmed, participants continue to be followed up by the PEP center according to the protocol.

Read the detailed description

Since its discovery in the Democratic Republic of Congo (DRC) in 1976, the EBOV virus has been responsible for numerous epidemics. Outbreaks have occurred in the DRC, Gabon, Guinea, Liberia and Sierra Leone. Imported cases were also discovered in 1996 in South Africa, and in 2014 in Mali, Nigeria, Senegal, Italy, Spain, UK and USA (1). To date, the largest EVD epidemic occurred in West Africa between 2014 and 2016. It was responsible for over 28,000 infections and more than 11,000 deaths (2-4). Since this epidemic, EVD has emerged and re-emerged regularly in Sub-Saharan Africa (SSA).

Post-exposure prophylaxis (PEP) is the treatment of people at high risk of EVD. The main aim of PEP is to intervene during the asymptomatic incubation period (2-21 days) to prevent the development of EVD.

In addition to preventing the disease in individuals, an effective PEP strategy could reduce the rate of secondary attacks, thus interrupting transmission chains. If introduced rapidly, this tool could halt the spread of the disease and contribute to the fight against EVD epidemics (5). The particular vulnerability of healthcare personnel has been highlighted during several outbreaks, due to their close contact with infected patients and contaminated equipment (6). With an effective and accessible PEP tool, it will be possible to ensure the safety and protection of these essential personnel and minimize the risk of nosocomial transmission within healthcare establishments. PEP could also benefit contact tracing efforts by providing an appropriate preventive measure. By integrating PEP into comprehensive epidemic response strategies, it will be possible to improve countries' ability to control and mitigate the public health impact of EVD epidemics and prevent future outbreaks.

There is currently no comprehensive PEP strategy, i.e. one that combines several interventions. Several prophylactic interventions have been evaluated, including vaccination and mAb immunotherapy, each with its advantages and limitations (7-9). Although not intended for this use, Ervebo vaccine is currently administered as PEP during EVD epidemics, by being administered to contacts regardless of exposure levels.

MAbs have been administered as PEP on a compassionate basis, to healthcare workers following occupational exposure, in line with WHO expert advice from 2018 (10). In addition, mAbs are recommended as PEP for newborns of Ebola-infected mothers, within seven days of birth (11). PEP can prevent the risk of infection associated with a particular contact, but not the persistent risk of infection during an epidemic. A comprehensive strategy to protect high-risk contacts must therefore be put in place, including both a drug to prevent EVD after contact (mAb or antiviral) and a vaccine for long-term immunity, to guarantee both immediate and prolonged protection.

Inmazeb (REGN-EB3), developed by Regeneron, is a cocktail of 3 neutralizing humanized mAbs directed against 3 EBOV GP epitopes (atoltiviMab, maftiviMab and odesiviMab). It is indicated for the treatment of EVD in adult patients (including pregnant women) and in children, including neonates whose mothers have EVD at the time of delivery. Inmazeb inhibits viral entry into the target cell (12). This mechanism of action makes Inmazeb a promising candidate for PEP (34,40-44). In phase 1, the optimal dose was set at 150 mg/kg as a single intravenous (IV) dose, with good tolerability, except for moderate side effects such as headache and myalgia in 30% and 10% of participants respectively. The longest half-life of the three antibodies was 27.3 days (21.7 and 23.3 for the other two antibodies). At 180 days, the residual concentration of each antibody (administered at 150 mg/kg) is less than 10 mg/l (13). In the PALM trial, overall mortality after a single 150 mg/kg dose was estimated at 33.5% (versus 51.3% in the ZMapp control arm). However, the effect of treatment is strongly influenced by viral load. In patients with a high viral load at inclusion (NP Ct \< 22), mortality was 63.6% (versus 86.2% in the Zmapp subgroup), while in patients with a low viral load at inclusion (NP Ct > 22), mortality was 11.2% (versus 25.8% in the Zmapp subgroup) (14). Following the PALM trial, Inmazeb was approved by the FDA for the treatment of EVD in adults and children (15).

A study conducted during the 10éme EVD epidemic in the DRC evaluated PEP with mAbs as part of a compassionate program (Post-Exposure Prophylaxis Monitored Emergency Used for Unregistered Intervention - PEP MEURI). In this study, 23 vaccine-naïve high-risk contacts received mAbs (21 Ebanga and 2 Inmazeb) after a median delay of one day between contact and PEP. At D14, none of the participants were symptom-free and their PCR was negative (16).

EBO-PEP is a multicentre, multi-epidemic, phase III, comparative, controlled, randomised, strict superiority trial in two unblinded parallel arms.

The trial will be open during EVD epidemics, and will recruit asymptomatic participants at high risk of developing EVD. Participants will be randomized (1:1) into one of two trial arms:

  • Arm 1 (control arm): Ervebo D1 (72 million PFU IM)
  • Arm 2: Ervebo D1 (72 million PFU IM) + Inmazeb IV (150 mg/kg) D1 + Ervebo D56 (revaccination)

Definition of high-risk:

Direct contact with a person with EBOV PCR-confirmed EVD with diarrhea, vomiting or external bleeding ("wet symptoms"), or with their body fluids; Direct contact with the dead body of a person with confirmed or probable EVD; Needlestick with a syringe contaminated by the blood of a person with confirmed or probable EVD; Or a child born to or breastfed by an individual with EVD

02

Conditions studied

  • Ebola Virus Disease

Keywords

  • Ebola Virus Disease
  • EBOV
  • High-Risk contact
  • Post-Exposure Prophylaxis
03

In context

Hemorrhagic Fever, Ebola

104 studies on the registry are indexed under Hemorrhagic Fever, Ebola; 13 are open to participants now.

This study's planned enrollment of 160 is above the median of 94 across 81 interventional studies indexed under Hemorrhagic Fever, Ebola.

Browse Hemorrhagic Fever, Ebola studies →

Lead sponsor

ANRS, Emerging Infectious Diseases is the lead sponsor of 215 studies on the registry; 38 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion criteria

  • Last high-risk contact within the last 5 days
  • No sign or symptoms of EVD
  • Signed and dated from participants over the age of majority to participate in the trial or from a representative of parental authority for minor participants.

Non-inclusion criteria

  • History of vaccination with Ervebo or any other EVD vaccine within the last 5 years (self-reported by the participant)
  • History of confirmed EVD within the last 5 years (self-reported by the participant)
  • to any of the experimental medical products (IMP) or their (self-reported by the participant)
  • Participation in another therapeutic or vaccine trial for EVD
  • Any other reason that, at the investigator's discretion, could compromise the participant's safety and cooperation in the trial.
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

05

Study design

Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
160 participants (estimated)

Study arms

  • Active comparator
    Ervebo vaccine alone

    Administration of Ervebo vaccine (72 million PFU IM) at day 1

    Biological: Ervebo

  • Experimental
    Ervebo + Inmazeb

    Administration of Ervebo vaccine (72 million PFU IM) and Inmazeb IV (150 mg/kg) at day 1 and Inmazeb IV (150 mg/kg) at day 56

    Biological: Ervebo · Biological: Inmazeb

Interventions

  • BiologicalErvebo

    Ebola Zaire vaccine (rVSV∆G-ZEBOV-GP, live, attenuated) ≥ 72 million PFU, composed of the Indiana strain of recombinant vesicular stomatitis virus (rVSV) with a deletion of the envelope glycoprotein (G) of VSV replaced by the surface glycoprotein (GP) of the Kikwit 1995 strain of Ebola virus Zaire (ZEBOV)

    Also known as: r-VSV-ZEBOV vaccine

  • BiologicalInmazeb

    Inmazeb (REGN-EB3), developed by Regeneron, is a cocktail of 3 neutralising humanised mAbs directed against 3 epitopes of the EBOV GP (atoltivimab, maftivimab and odesivimab). It is indicated for the treatment of EVD in adult patients (including pregnant women) and in children, including neonates born to mothers with confirmed EVD.

    Also known as: REGN-EB3

06

What researchers measure

Primary outcomes

  1. Proportion of participants with EBOV PCR-confirmed symptomatic EVD

    EVD rate

    Time frame: Between Day 1 and Day 21

Secondary outcomes

  1. Proportion of participants with EBOV PCR-confirmed symptomatic EVD

    EVD rate

    Time frame: Between Day 1 and Day 60

  2. Safety and tolerance

    Proportion of participants with a grade 3 or higher Adverse Event

    Time frame: Between Day 1 and Day 60

  3. Severity of EVD

    Proportion of participants admitted to the Ebola Treatment Center with confirmed EVD meeting at least one of the following criteria: * Nucleoprotein cycle threshold (NP Ct) \< 22 * KDIGO stage 3 * ASAT or ALAT \> 5N * External bleeding * AVPU score * NEWS2 score ≥ 7

    Time frame: Between Day 1 and Day 60

  4. Proportion of participants with asymptomatic EVD

    Rate of PCR-confirmed EVD

    Time frame: Between Day 1 and Day 21

  5. Proportion of deaths

    Proportion of participants who died (all causes combined)

    Time frame: Between Day 1 and Day 60

  6. Changes in viral load

    NP Ct curve (nucleoprotein cycle threshold)

    Time frame: Between Day 1 and Day 21

  7. Estimating cost-effectiveness

    Incremental cost-effectiveness ratio (ICER) for ERV+IMZ arm vs ERV

    Time frame: Between Day 1 and up to Day 60

07

Study locations

4 sites
  • National Institute for Biomedical Research (INRB)
    Kinshasa, Democratic Republic of the Congo
  • Guinea Centre for Research and Training in Infectious Diseases (CERFIG)
    Conakry, Guinea
  • National Public Health Institute of Liberia
    Monrovia, Liberia
  • University of Sierra Leone College of Medicine and Allied Health Sciences
    Freetown, Sierra Leone
08

References and documents

Publications

  • Huttner A, Agnandji ST, Combescure C, Fernandes JF, Bache EB, Kabwende L, Ndungu FM, Brosnahan J, Monath TP, Lemaitre B, Grillet S, Botto M, Engler O, Portmann J, Siegrist D, Bejon P, Silvera P, Kremsner P, Siegrist CA; VEBCON; VSV-EBOVAC; VSV-EBOPLUS Consortia. Determinants of antibody persistence across doses and continents after single-dose rVSV-ZEBOV vaccination for Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2018 Jul;18(7):738-748. doi: 10.1016/S1473-3099(18)30165-8. Epub 2018 Apr 5. PubMed 29627147 ↗
  • Isa F, Gonzalez Ortiz AM, Meyer J, Hamilton JD, Olenchock BA, Brackin T, Ganguly S, Forleo-Neto E, Faria L, Heirman I, Marovich M, Hutter J, Polakowski L, Irvin SC, Thakur M, Hooper AT, Baum A, Petro CD, Fakih FA, McElrath MJ, De Rosa SC, Cohen KW, Williams LD, Hellman CA, Odeh AJ, Patel AH, Tomaras GD, Geba GP, Kyratsous CA, Musser B, Yancopoulos GD, Herman GA; Trial Working Group. Effect of timing of casirivimab and imdevimab administration relative to mRNA-1273 COVID-19 vaccination on vaccine-induced SARS-CoV-2 neutralising antibody responses: a prospective, open-label, phase 2, randomised controlled trial. Lancet Infect Dis. 2025 Jan;25(1):52-67. doi: 10.1016/S1473-3099(24)00421-3. Epub 2024 Sep 2. PubMed 39236733 ↗
  • Cao L, Li Y, Yang S, Li G, Zhou Q, Sun J, Xu T, Yang Y, Liao R, Shi Y, Yang Y, Zhu T, Huang S, Ji Y, Cong F, Luo Y, Zhu Y, Luan H, Zhang H, Chen J, Liu X, Luo R, Liu L, Wang P, Yu Y, Xing F, Ke B, Zheng H, Deng X, Zhang W, Lin C, Shi M, Li CM, Zhang Y, Zhang L, Dai J, Lu H, Zhao J, Zhang X, Guo D. The adenosine analog prodrug ATV006 is orally bioavailable and has preclinical efficacy against parental SARS-CoV-2 and variants. Sci Transl Med. 2022 Sep 7;14(661):eabm7621. doi: 10.1126/scitranslmed.abm7621. Epub 2022 Sep 7. PubMed 35579533 ↗
  • Jaspard M, Juchet S, Serra B, Mayoum B, Kanta IM, Camara MS, Mbala P, Kojan R, Malvy D. Post-exposure prophylaxis following high-risk contact with Ebola virus, using immunotherapies with monoclonal antibodies, in the eastern Democratic Republic of the Congo: an emergency use program. Int J Infect Dis. 2021 Dec;113:166-167. doi: 10.1016/j.ijid.2021.09.053. Epub 2021 Sep 26. PubMed 34587535 ↗
  • PREVAC Study Team; Kieh M, Richert L, Beavogui AH, Grund B, Leigh B, D'Ortenzio E, Doumbia S, Lhomme E, Sow S, Vatrinet R, Roy C, Kennedy SB, Faye S, Lees S, Millimouno NP, Camara AM, Samai M, Deen GF, Doumbia M, Esperou H, Pierson J, Watson-Jones D, Diallo A, Wentworth D, McLean C, Simon J, Wiedemann A, Dighero-Kemp B, Hensley L, Lane HC, Levy Y, Piot P, Greenwood B, Chene G, Neaton J, Yazdanpanah Y. Randomized Trial of Vaccines for Zaire Ebola Virus Disease. N Engl J Med. 2022 Dec 29;387(26):2411-2424. doi: 10.1056/NEJMoa2200072. Epub 2022 Dec 14. PubMed 36516078 ↗
  • Sivapalasingam S, Kamal M, Slim R, Hosain R, Shao W, Stoltz R, Yen J, Pologe LG, Cao Y, Partridge M, Sumner G, Lipsich L. Safety, pharmacokinetics, and immunogenicity of a co-formulated cocktail of three human monoclonal antibodies targeting Ebola virus glycoprotein in healthy adults: a randomised, first-in-human phase 1 study. Lancet Infect Dis. 2018 Aug;18(8):884-893. doi: 10.1016/S1473-3099(18)30397-9. Epub 2018 Jun 18. PubMed 29929783 ↗
  • Pascal KE, Dudgeon D, Trefry JC, Anantpadma M, Sakurai Y, Murin CD, Turner HL, Fairhurst J, Torres M, Rafique A, Yan Y, Badithe A, Yu K, Potocky T, Bixler SL, Chance TB, Pratt WD, Rossi FD, Shamblin JD, Wollen SE, Zelko JM, Carrion R Jr, Worwa G, Staples HM, Burakov D, Babb R, Chen G, Martin J, Huang TT, Erlandson K, Willis MS, Armstrong K, Dreier TM, Ward AB, Davey RA, Pitt MLM, Lipsich L, Mason P, Olson W, Stahl N, Kyratsous CA. Development of Clinical-Stage Human Monoclonal Antibodies That Treat Advanced Ebola Virus Disease in Nonhuman Primates. J Infect Dis. 2018 Nov 22;218(suppl_5):S612-S626. doi: 10.1093/infdis/jiy285. PubMed 29860496 ↗
  • Moso MA, Lim CK, Williams E, Marshall C, McCarthy J, Williamson DA. Prevention and post-exposure management of occupational exposure to Ebola virus. Lancet Infect Dis. 2024 Feb;24(2):e93-e105. doi: 10.1016/S1473-3099(23)00376-6. Epub 2023 Sep 15. PubMed 37722397 ↗
  • Crozier I, Britson KA, Wolfe DN, Klena JD, Hensley LE, Lee JS, Wolfraim LA, Taylor KL, Higgs ES, Montgomery JM, Martins KA. The Evolution of Medical Countermeasures for Ebola Virus Disease: Lessons Learned and Next Steps. Vaccines (Basel). 2022 Jul 29;10(8):1213. doi: 10.3390/vaccines10081213. PubMed 36016101 ↗
  • Fischer WA 2nd, Vetter P, Bausch DG, Burgess T, Davey RT Jr, Fowler R, Hayden FG, Jahrling PB, Kalil AC, Mayers DL, Mehta AK, Uyeki TM, Jacobs M. Ebola virus disease: an update on post-exposure prophylaxis. Lancet Infect Dis. 2018 Jun;18(6):e183-e192. doi: 10.1016/S1473-3099(17)30677-1. Epub 2017 Nov 15. PubMed 29153266 ↗
  • Bower H, Johnson S, Bangura MS, Kamara AJ, Kamara O, Mansaray SH, Sesay D, Turay C, Checchi F, Glynn JR. Exposure-Specific and Age-Specific Attack Rates for Ebola Virus Disease in Ebola-Affected Households, Sierra Leone. Emerg Infect Dis. 2016 Aug;22(8):1403-11. doi: 10.3201/eid2208.160163. Epub 2016 Aug 15. PubMed 27144428 ↗
  • Hoffmann Dahl E, Mbala P, Juchet S, Toure A, Montoyo A, Serra B, Kojan R, D'Ortenzio E, Blomberg B, Jaspard M. Improving Ebola virus disease outbreak control through targeted post-exposure prophylaxis. Lancet Glob Health. 2024 Oct;12(10):e1730-e1736. doi: 10.1016/S2214-109X(24)00255-9. Epub 2024 Sep 10. PubMed 39270687 ↗
  • Languon S, Quaye O. Filovirus Disease Outbreaks: A Chronological Overview. Virology (Auckl). 2019 Jun 21;10:1178122X19849927. doi: 10.1177/1178122X19849927. eCollection 2019. PubMed 31258326 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Sep 2026; primary completion for Aug 2027, 11 months later.

How these figures are worked out, and which studies are left out of them.

Registered
Jan 28, 2025
First posted
Feb 24, 2025
StartEst.
Sep 2026
Primary completionEst.
Aug 1, 2027
CompletionEst.
Aug 1, 2028
Last update
Jan 22, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jan 22, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06841614
Collaborators
Alliance for International Medical Action, Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Medecins Sans Frontieres, Netherlands, Barcelona Institute for Global Health, University of Bordeaux, INSERM UMR S 1136, Agence Nationale de Sécurité Sanitaire de Guinée (ANSS), National Institute for Biomedical Research DRC, Cheikh Anta Diop University, Senegal, PACCI Program, The PANdemic preparedness plaTform for Health and Emerging infectious Response, University of Sierra Leone, National Public Health Institute of Liberia
Responsible party
Sponsor
First posted
Feb 24, 2025
Start date
Sep 2026 (estimated)
Primary completion
Aug 1, 2027 (estimated)
Completion
Aug 1, 2028 (estimated)
Last update
Jan 22, 2026

Study contacts

Marie JASPARD, MD, PHD
Contact
marie.jaspard@aphp.fr
0658809012 ext. +33
Alice MONTOYO, PharmD
Contact
alice.montoyo@alima.coral.ngo
0660162965 ext. +33
Placide MBALA, MD, MSPH, PhD
study chair · INRB

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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