A recent systematic review comparing the efficacy of tecovirimat, cidofovir, brincidofovir, trifluridine, and vaccinia immune globulin intravenous at treating patients with the mpox infection found tecovirimat to be the most effective, according to a report from Infectious Diseases Advisor. In the new review—published by Shamim et al in the International Journal of Infectious Diseases—investigators identified 18 studies involving 71 patients treated with the antivirals for their mpox infections. Among the 71 patients, the investigators noted that 83.1% (n = 59) of them were disease-free following treatment with the medications. For those who were given tecovirimat—in combination with vancomycin, piperacillin/tazobactam, dexamethasone, acyclovir, fluconazole, or penicillin—symptoms of burning sensations; fevers; and lesions of the face, mouth, trunk, and extremities resolved within days. Though rare, side effects of fatigue, headaches, nausea, loose stools, and temporary spikes in hepatic enzyme levels were noted for those taking tecovirimat. Patients who took cidofovir also saw positive outcomes, though one patient saw worsening of their ocular lesions. Trifluridine eye drops benefited three of the four patients who received the treatment, with the fourth experiencing vision impairment. Additionally, the use of brincidofovir—which caused high hepatic enzyme levels among all patients who took the medication, conjunctivitis, lower extremity abscesses, and neuropsychiatric side effects—was discontinued. “The promising results seen with tecovirimat should be investigated further in well-designed research,” concluded the investigators, emphasizing that their analyses revealed that the medication had a better safety profile than the other antivirals included in the study.
May 25, 2023