Therapeutic strategies to address monkeypox

ABSTRACT

Introduction

Monkeypox is a viral zoonosis, with symptoms similar to those seen in smallpox patients, although the clinical presentation may be less severe. Until recently, human monkeypox infection was rare, and primarily occurred in Central and West Africa.

Areas covered

An international outbreak began in May 2022, and monkeypox has now been detected on every continent except Antarctica. The first recognized case from the current outbreak was confirmed in the United Kingdom on 6 May 2022, in an adult with travel links to Nigeria, but it has been suggested that cases had been spreading in Europe for months. On 23 July 2022 the Director-General of the World Health Organization declared the monkeypox outbreak a public health emergency of international concern.

Expert opinion

There are no treatments specifically for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, and therapeutics developed to combat smallpox may be used to treat monkeypox. This manuscripts reviews what is known about these potential treatments, including tecovirimat and brincidofovir, based on a literature search of PubMed through 9 August 2022, and explores how these therapeutics may be used in the future to address the expanding monkeypox pandemic.

KEYWORDS:

• Monkeypox
• tecovirimat
• brincidofovir
• sars-cov-2
• smallpox

Article highlights

• An international monkeypox outbreak began in May 2022, and the virus has now been detected on every continent except Antarctica.

• There are no approved treatments for monkeypox virus infections.

• Monkeypox and smallpox viruses are genetically similar, and therapeutics developed to combat smallpox could potentially be used to treat monkeypox.

• The antiviral agents tecovirimat and brincidofovir have activity against monkeypox virus

• Data from randomized clinical trials is urgently needed to address the expanding monkeypox outbreak

• On 25 June 2022, the World Health Organization announced that the global monkeypox outbreak does not constitute a public health emergency of international concern.

• On 23 July 2022 the Director-General of the World Health Organization declared the monkeypox outbreak a public health emergency of international concern.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or mending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.