The research is among the earliest to evaluate and document the effects of using this antiviral drug to treat patients with monkeypox.
Tecovirimat (TPOXX) is an FDA-approved antiviral drug for the treatment of smallpox. By impeding the function of the protein involved in releasing the enveloped virus, it prevents viral spread within the body. In order to treat adults and children with orthopoxvirus infections, including monkeypox, the Centers for Disease Control and Prevention (CDC) recently permitted physicians to prescribe tecovirimat on a compassionate use basis.
Experts in infectious diseases from UC Davis provided information on 25 monkeypox patients who received tecovirimat therapy in a research letter that was published in the journal JAMA.
"On the use of tecovirimat for monkeypox infection, we have a minimal amount of clinical information. There is still a lot to learn about the disease's typical course and how tecovirimat and other antivirals might impact it "Angel Desai, the lead author, said. At UC Davis Health, she specializes in infectious diseases of adults.
The recent global outbreak of monkeypox has led to more than 45,500 cases as of August 22, 2022. A recent study found that 13% of patients required hospitalization, despite the fact that symptoms typically go away on their own in 2-4 weeks.
Between June 3 and August 13, 2022, patients who were referred to the UC Davis Medical Center, primarily by the Sacramento County Department of Public Health, were included in the new study.
Oral tecovirimat was prescribed for patients who had skin lesions on multiple body parts or in delicate locations like the face or genital area. A high-fat meal should be consumed within 30 minutes of the weight-based treatment, and administered every 8 or 12 hours.
Clinical data were gathered at the initial in-person assessment for treatment as well as on days 7 and 21 after the start of therapy through in-person or telephone interviews.
25 patients with a confirmed monkeypox infection finished the tecovirimat therapy regimen in total. They were all men. They were between the ages of 27 and 76. (the median age was 40). HIV was found in 9 patients.
Four patients received a dose of JYNNEOS vaccination after symptoms appeared, while only one patient had the smallpox vaccine (taken more than 25 years ago).
According to the study, 92% of patients had lesions in their anal or genital regions. All patients had painful lesions, but only about half of them had fewer than 10 spots all over their bodies.
Prior to beginning their antiviral therapy, the patients had symptoms or lesions on average for 12 days. The majority of the patients (76%) had a fever, which was followed by fatigue (32%), a sore throat (20%), and chills (20%). Other symptoms included backache (12%), muscle pain (8%), nausea (4%), and diarrhoea (4%).
All of the patients finished the tecovirimat therapy and responded favourably to the medication. With the exception of one patient, they all received treatment for two weeks.
40% of patients had recovered from their lesions by day 7 of treatment. 92% had recovered and experienced no pain by day 21.
On day seven of therapy, the most common side effects were fatigue (28%), headache (20%), nausea (16%), itching (8%), and diarrhoea (8%).
"We must be extremely cautious when interpreting the data. It can be challenging to distinguish between side effects brought on by therapy and those brought on by an infection "said co-author and expert on infectious diseases George Thompson. Thompson teaches in the departments of internal medicine, infectious diseases, and medical microbiology and immunology at the UC Davis School of Medicine.
There was no control group and the study was small. Thus, measuring antiviral effectiveness in terms of the persistence and severity of symptoms was difficult. The interval between the onset of symptoms and the start of antiviral therapy also varied among the patients.
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