Monkeypox treatment: Current evidence and future perspectives

As of September 11, 2022, 57 669 reports of monkeypox infection raised global concern. Previous vaccinia virus vaccination can protect from monkeypox. However, after smallpox eradication, immunization against that was stopped. Indeed, therapeutic options following the disease onset are of great valu...

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Bibliographic Details
Published in:Journal of medical virology 2023-01, Vol.95 (1), p.e28229-n/a
Main Authors: Khani, Elnaz, Afsharirad, Bentelhoda, Entezari‐Maleki, Taher
Format: Article
Language:English
Subjects:
Animal models
Animals
Antiviral agents
Availability
Benzamides
Clinical trials
Health services
Immunization
Isoindoles - therapeutic use
local infection/replication/spread
Mpox
Mpox (monkeypox) - drug therapy
Mpox (monkeypox) - prevention & control
Orthopoxvirus
Patients
Pharmacokinetics
poxvirus
Smallpox
Smallpox - drug therapy
Vaccination
Vaccines
Virology
Viruses
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Summary:As of September 11, 2022, 57 669 reports of monkeypox infection raised global concern. Previous vaccinia virus vaccination can protect from monkeypox. However, after smallpox eradication, immunization against that was stopped. Indeed, therapeutic options following the disease onset are of great value. This study aimed to review the available evidence on virology and treatment approaches for monkeypox and provide guidance for patient care and future studies. Since no randomized clinical trials were ever performed, we reviewed monkeypox animal model studies and clinical trials on the safety and pharmacokinetics of available medications. Brincidofovir and tecovirimat were the most studied medications that got approval for smallpox treatment according to the Animal Rule. Due to the conserved virology among Orthopoxviruses, available medications might also be effective against monkeypox. However, tecovirimat has the strongest evidence to be effective and safe for monkeypox treatment, and if there is a choice between the two drugs, tecovirimat has shown more promise so far. The risk of resistance should be considered in patients who failed to respond to tecovirimat. Hence, the target‐based design of novel antivirals will enhance the availability and spectrum of effective anti‐Orthopoxvirus agents.
ISSN:0146-6615
1096-9071
DOI:10.1002/jmv.28229