No sooner has monkeypox spread in Europe and beyond than scientists are already looking for a treatment for the infectious disease. A new study in the journal “The Lancet Infectious Diseases” now provides an indication of a possible therapy.
A research team led by tropical medicine specialist Hugh Adler from the Liverpool University Hospitals NHS Foundation Trust examined the disease course of seven monkeypox cases in Great Britain between August 2018 and September 2021.
Three infected people took 200 milligrams of the antiviral drug brincidofovir against monkeypox in the hospital every week. The treatment had to be ended prematurely after one or two doses because the patients had elevated liver values after taking the drug. Another three infected people were not taking any medication for monkeypox.
The seventh patient was treated with tecovirimat for monkeypox. The dosage: 600 milligrams, twice a day for two weeks. According to the researchers, the woman showed no undesirable side effects, was less infectious and recovered more quickly after ten days of treatment in the hospital. The other six patients were hospitalized for between 13 and 35 days.
“However, we cannot say whether this was a result of treatment with Tecovirimat,” the researchers concede in their study Drug against different types of smallpox virus – that has been known for a long time.”
Despite the very small number of cases, the study confirms previous preclinical and clinical data on the preparation. “I consider Tecovirimat to be a particularly recommended drug for the treatment of monkeypox,” said the scientist.
Due to the close genetic relationship between various smallpox viruses Tecovirimat could also help against monkeypox. Because, according to Sutter, the drug also works very specifically against smallpox viruses, undesirable side effects are rare.
“Brincidofovir, on the other hand, inhibits the spread of the virus by introducing defective components into infected and healthy body cells.” This is a less targeted mechanism and side effects would occur more frequently as a result.
The virologist does not expect large studies with thousands of patients, such as with possible Covid 19 drugs, because the numbers for monkeypox infections would probably be much lower than for the corona pandemic.
Both drugs, brincidofovir and tecovirimate, are approved in the UK to treat a variety of smallpox diseases. In the macaque monkey species, tecovirimat reduced the number of pustules and vesicles as a result of the disease to a similar extent as in the patient in the Lancet study. In the animals, the monkeypox virus was also no longer detectable in the blood and in the upper respiratory tract.
The antiviral drug brincidofovir increased the chances of survival for ground squirrels with advanced monkeypox infection from 14 percent to 29 percent in another study.
Three of the seven patients examined contracted monkeypox in Great Britain: a hospital worker became infected in the clinic, an adult and a child contracted a patient infected in Nigeria. The other four got infected after a trip to Nigeria. The researchers were able to detect the monkeypox virus in the blood and in the upper respiratory tract.
Because the number of monkeypox cases examined in the study is too small, the scientists did not carry out an analysis, but presented the clinical data of the individual patients in tabular form. The information includes, among other things, the country of origin of the infection, how the blisters and pustules have spread over the body of the patient and the number of treatment days in the hospital.
“Our study provides the first evidence for the use of antiviral drugs against monkeypox in humans,” said lead author Hugh Adler. “Although the recent outbreak has affected more patients in the UK than previously, monkeypox has not spread very widely among humans and the risk to public health is low.”
As of Saturday May 21, the World Health Organization reported 92 confirmed cases of monkeypox in Germany and 11 other member states that do not normally have monkeypox outbreaks. Experts describe such countries as “non-endemic”. 28 other suspected cases still had to be checked at the time of the survey.
In May, the health authorities reported cases of monkeypox in Germany for the first time. Experts from the Robert Koch Institute (RKI) commented on the situation on the website on Tuesday as follows: “What is special about these cases is that those affected had not previously traveled to African countries, as they had in the past the virus is endemic (West and Central Africa) and that many transmissions could apparently have taken place in the context of sexual activities.” According to the assessment, a noticeably large number of men who had sex with other men became infected.
According to current knowledge, the RKI estimates the risk to the health of the general population in Germany to be low.
According to the World Health Organization, monkeypox is suspected if, on the one hand, there is an inexplicable acute skin rash and, on the other hand, at least one of the following symptoms occurs: fever of over 38.5 degrees, swollen lymph nodes, muscle and joint pain, back pain or weakness.
According to the EU health authorities, the monkeypox virus could be particularly dangerous for small children, pregnant women and people with a weakened immune system. Previous cases have often been mild. The World Health Organization is not aware of any deaths from or with monkeypox in non-endemic countries such as Germany, France or Spain.