TY - JOUR
T1 - The use of antivirals in the treatment of human monkeypox outbreaks
T2 - a systematic review
AU - Shamim, Muhammad Aaqib
AU - Padhi, Bijaya Kumar
AU - Satapathy, Prakasini
AU - Veeramachaneni, Sai D.
AU - Chatterjee, Chandrima
AU - Tripathy, Snehasish
AU - Akhtar, Naushaba
AU - Pradhan, Anindita
AU - Dwivedi, Pradeep
AU - Mohanty, Aroop
AU - Rodriguez-Morales, Alfonso J.
AU - Sah, Ranjit
AU - Al-Tammemi, Ala'a B.
AU - Al-Tawfiq, Jaffar A.
AU - Nowrouzi-Kia, Behdin
AU - Chattu, Vijay Kumar
N1 - Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Ethical approval is not required for this study. We wish to thank Dr. Shailesh Advani (Terasaki Institute of Biomedical Innovation) and Dr. Gitismita Naik (All India Institute of Medical Sciences, Kalyani) for their assistance during the development of the protocol of this systematic review. We also thank Dr. Rabbanie Tariq Wani (Directorate of Health Services, Kashmir) for suggesting a few edits in the text. BKP, MAS, and SDV conceptualized and designed the study. MAS, SDV, CC, ST, PS, CC, and ST were involved in the screening of articles, assessment of the risk of bias, and data extraction. MAS, BKP, VKC, and JAT contributed to the methodology. Software, data analysis, and interpretation were done by AP, PD, AM, AJR, RS, ATA, and JAT. Project administration was done by BKP, RS, and VKC. Resources were provided by BNK, VKC, and RS. The original draft of various sections in the initial phase was contributed by MAS, NA, AP, and BKP. BNK, VKC, and JAT provided critical comments and edited the final draft. Each author had access to all the data in the study and provided inputs to the preparation of the final manuscript. All the authors accepted the final version of the manuscript. All data used in this review were obtained from studies available online. The protocol has been made publicly available at International Prospective Register of Systematic Reviews, CRD42022355596.
Publisher Copyright:
© 2022 The Author(s)
PY - 2023/2
Y1 - 2023/2
N2 - Objectives: Human monkeypox virus (MPXV) infection is a recently declared public health emergency of international concern by the World Health Organization. Besides, there is scant literature available on the use of antivirals in MPXV infection. This systematic review compiles all evidence of various antivirals used on their efficacy and safety and summarizes their mechanisms of action. Methods: A review was done of all original studies mentioning individual patient data on the use of antivirals in patients with MPXV infection. Results: Of the total 487 non-duplicate studies, 18 studies with 71 individuals were included. Tecovirimat was used in 61 individuals, followed by cidofovir in seven and brincidofovir (BCV) in three individuals. Topical trifluridine was used in four ophthalmic cases in addition to tecovirimat. Of the total, 59 (83.1%) were reported to have complete resolution of symptoms; one was experiencing waxing and waning of symptoms, only one (1.8%) had died, and the others were having a resolution of symptoms. The death was thought unrelated to tecovirimat. Elevated hepatic panels were reported among all individuals treated with BCV (leading to treatment discontinuation) and five treated with tecovirimat. Conclusion: Tecovirimat is the most used and has proven beneficial in several aggravating cases. No major safety concerns were detected upon its use. Topical trifluridine was used as an adjuvant treatment option along with tecovirimat. BCV and cidofovir were seldom used, with the latter often being used due to the unavailability of tecovirimat. BCV was associated with treatment discontinuation due to adverse events.
AB - Objectives: Human monkeypox virus (MPXV) infection is a recently declared public health emergency of international concern by the World Health Organization. Besides, there is scant literature available on the use of antivirals in MPXV infection. This systematic review compiles all evidence of various antivirals used on their efficacy and safety and summarizes their mechanisms of action. Methods: A review was done of all original studies mentioning individual patient data on the use of antivirals in patients with MPXV infection. Results: Of the total 487 non-duplicate studies, 18 studies with 71 individuals were included. Tecovirimat was used in 61 individuals, followed by cidofovir in seven and brincidofovir (BCV) in three individuals. Topical trifluridine was used in four ophthalmic cases in addition to tecovirimat. Of the total, 59 (83.1%) were reported to have complete resolution of symptoms; one was experiencing waxing and waning of symptoms, only one (1.8%) had died, and the others were having a resolution of symptoms. The death was thought unrelated to tecovirimat. Elevated hepatic panels were reported among all individuals treated with BCV (leading to treatment discontinuation) and five treated with tecovirimat. Conclusion: Tecovirimat is the most used and has proven beneficial in several aggravating cases. No major safety concerns were detected upon its use. Topical trifluridine was used as an adjuvant treatment option along with tecovirimat. BCV and cidofovir were seldom used, with the latter often being used due to the unavailability of tecovirimat. BCV was associated with treatment discontinuation due to adverse events.
KW - Antiviral
KW - Brincidofovir
KW - Cidofovir
KW - Monkeypox
KW - Tecovirimat
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85145998883&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2022.11.040
DO - 10.1016/j.ijid.2022.11.040
M3 - Artículo de revisión
C2 - 36470502
AN - SCOPUS:85145998883
SN - 1201-9712
VL - 127
SP - 150
EP - 161
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -
