Therapeutic agents for the treatment of human mpox.

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES Current Opinion in Infectious Diseases Pub Date : 2024-12-01 Epub Date: 2024-10-09 DOI:10.1097/QCO.0000000000001069
Maxwell Braddick, Kasha Priya Singh
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Abstract

Purpose of review: The aim of this study was to summarize the current knowledge of therapeutic options for mpox (formerly known as monkeypox) in the context of recent outbreaks and the ongoing evolution of the virus.

Recent findings: Multiple therapeutic agents, including tecovirimat, cidofovir, brincidofovir, and vaccinia immune globulin, have been used during the multicountry outbreak of mpox caused by Clade 2b monkeypox virus that began in 2022. Tecovirimat has been most extensively used, based on efficacy against mpox lethal challenge in animal models, and human safety data. Real-world observational evidence has further supported safety with minimal adverse events in large cohorts and mixed reports of reductions in time to lesion resolution. Several prospective randomized controlled trials using tecovirimat are underway with headline results from a study in the Democratic Republic of the Congo showing no difference in lesion resolution compared to placebo. Other studies including in outpatient settings are underway in Europe and the Americas. Cidofovir and brincidofovir, limited by adverse event profiles, have been less extensively studied. Vaccinia immune globulin has been used predominantly in salvage therapy for severe mpox, with no large observational series available.

Summary: The 2022 multicountry outbreak of mpox marked a public health emergency. Agents approved for smallpox management were widely used for mpox, supported by animal and in-vitro evidence, and human safety data. The large number of human cases has allowed retrospective observational study of these agents and facilitated recruitment in prospective trials. The ongoing evolution of the virus may pose challenges for therapeutic interventions, necessitating rigorous randomized controlled trials to guide clinical use.

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治疗人类麻疹的药物。
综述的目的:本研究的目的是根据最近的痘痘爆发情况和病毒的不断演变,总结目前有关痘痘(以前称为猴痘)治疗方案的知识:最近的研究结果:在2022年开始的由2b型猴痘病毒引起的多国疫情中,使用了多种治疗药物,包括替考韦酯、西多福韦酯、布林昔多福韦酯和疫苗免疫球蛋白。根据动物模型对天花致死性挑战的疗效和人类安全性数据,特考韦瑞马得到了最广泛的使用。现实世界的观察证据进一步证实了该药物的安全性,在大型群组中不良反应极少,而关于缩短病变消退时间的报道不一。目前正在进行几项使用特考韦瑞的前瞻性随机对照试验,在刚果民主共和国进行的一项研究的初步结果显示,与安慰剂相比,病灶消退时间没有差异。欧洲和美洲正在进行其他研究,包括在门诊环境中进行的研究。西多福韦(Cidofovir)和布林昔多福韦(brincidofovir)受不良反应的限制,研究较少。疫苗免疫球蛋白主要用于重症天花的抢救治疗,目前还没有大型的观察性系列研究。摘要:2022 年多国爆发的天花疫情标志着一场公共卫生紧急事件。在动物和体外证据以及人类安全性数据的支持下,获准用于治疗天花的药物被广泛用于治疗水痘。大量的人类病例使得人们可以对这些药物进行回顾性观察研究,并促进了前瞻性试验的招募。病毒的不断演变可能会给治疗干预带来挑战,因此有必要进行严格的随机对照试验,以指导临床使用。
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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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