Antiviral Therapy for Measles: Progress, Challenges and Perspectives

Despite the availability of an effective vaccine, measles remains a major cause of pediatric morbidity and mortality worldwide. This review aims to evaluate advances toward the development of specific antiviral treatments for measles by examining current candidates, their molecular targets, available preclinical and clinical data, and key challenges to therapeutic application.

An extensive literature search (2000-2026) was conducted using PubMed and official databases (WHO, CDC), including in vitro and in vivo studies (animal models), clinical trials, and international guidelines. The main agents included were ribavirin, favipiravir, remdesivir, ERDRP-0519, GHP-88309, fusion peptide inhibitors, and monoclonal antibodies.

No antiviral is yet approved specifically for measles; however, several candidates show promise. Ribavirin, a broad-spectrum antiviral, has demonstrated in vitro inhibition of measles virus and clinical benefit in severe cases (especially in immunocompromised patients), although data remain limited. Novel polymerase inhibitors such as ERDRP-0519 and its derivative GHP-88309 have shown effective post-exposure protection in animal models. Nucleoside analogs initially developed for other viruses (favipiravir, remdesivir) exhibit in vitro anti-measles activity. Peptides and monoclonal antibodies targeting the viral fusion protein also demonstrate encouraging results.

Antiviral therapy may improve the management of severe or post-exposure cases, especially in non-vaccinable individuals.

While vaccination remains the cornerstone of prevention, antiviral therapy may improve the management of severe or post-exposure cases, especially in non-vaccinable individuals. Clinical trials are needed to validate these strategies and consider their integration into future global measles elimination programs.