Youssef Rizk, Giuseppe Lippi, Brandon M Henry, Kin Israel Notarte, John G Rizk
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The Jynneos<sup>TM</sup> vaccine, recommended for high-risk individuals, has seen limited uptake despite its efficacy in preventing disease. Tecovirimat, while FDA-approved for smallpox and available in the European Union for mpox, has shown mixed results in recent trials, with new data suggesting limited effectiveness in Clade I infections and emergence of new mutations with resistance to this drug. Brincidofovir and Vaccinia Immune Globulin Intravenous offer additional treatment options, particularly for severe cases, although their use is constrained by regulatory and logistical challenges. Furthermore, the WHO recently approved the first commercial molecular assay, the Alinity m MPXV assay by Abbott Molecular Inc., for emergency use-an essential step in expanding testing capacity in regions experiencing mpox outbreaks. These updates underscore the critical need for continued research to enhance therapeutic outcomes and adapt public health strategies. 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引用次数: 0
摘要
由猴痘病毒(MPXV)引起的猴痘分为两个主要支系:支系 I 和支系 II,其中支系 IIb 的疫情较为突出。猴痘历来在非洲流行,近年来已在全球范围内显著蔓延。世界卫生组织(WHO)于 2024 年 8 月宣布 mpox 为国际关注的公共卫生紧急事件,强调了 Ib 支系在非洲以外地区的出现以及疫情对人口影响的扩大。本综述更新了麻痘疫苗和治疗方法的现状,包括其安全性和有效性。美国食品和药物管理局 (FDA) 批准了两种用于预防麻痘的疫苗:JynneosTM 和 ACAM2000®。JynneosTM 疫苗被推荐用于高危人群,尽管在预防疾病方面效果显著,但使用率有限。Tecovirimat 虽然已被美国食品及药物管理局批准用于天花,并在欧盟用于水痘,但最近的试验结果喜忧参半,新的数据表明它对 I 族感染的疗效有限,而且出现了对这种药物产生抗药性的新变异。Brincidofovir 和疫苗免疫球蛋白静脉注射提供了更多的治疗选择,尤其是针对重症病例,尽管它们的使用受到监管和后勤挑战的限制。此外,世卫组织最近批准了首个商业分子检测方法--雅培分子公司的 Alinity m MPXV 检测方法--用于紧急用途,这是扩大麻腮风疫情爆发地区检测能力的重要一步。这些更新强调了继续开展研究以提高治疗效果和调整公共卫生战略的迫切需要。在全球社会应对不断变化的水痘疫情时,确保公平获得疫苗、治疗和诊断方法仍然是一项重大挑战。
Update on Mpox Management: Epidemiology, Vaccines and Therapeutics, and Regulatory Changes.
Mpox, caused by the monkeypox virus (MPXV), is categorized into two primary clades: Clade I and Clade II, with notable outbreaks linked to Clade IIb. Historically endemic in Africa, recent years have seen significant global spread. The World Health Organization (WHO) declared mpox a Public Health Emergency of International Concern in August 2024, highlighting the emergence of Clade Ib outside Africa and the broadening demographic impact of the outbreak. This review updates the current status of mpox vaccines and treatments, including their safety and effectiveness. There are two US Food and Drug Administration (FDA)-approved vaccines for the prevention of mpox disease, JynneosTM and ACAM2000®. The JynneosTM vaccine, recommended for high-risk individuals, has seen limited uptake despite its efficacy in preventing disease. Tecovirimat, while FDA-approved for smallpox and available in the European Union for mpox, has shown mixed results in recent trials, with new data suggesting limited effectiveness in Clade I infections and emergence of new mutations with resistance to this drug. Brincidofovir and Vaccinia Immune Globulin Intravenous offer additional treatment options, particularly for severe cases, although their use is constrained by regulatory and logistical challenges. Furthermore, the WHO recently approved the first commercial molecular assay, the Alinity m MPXV assay by Abbott Molecular Inc., for emergency use-an essential step in expanding testing capacity in regions experiencing mpox outbreaks. These updates underscore the critical need for continued research to enhance therapeutic outcomes and adapt public health strategies. Ensuring equitable access to vaccines, treatments, and diagnostics remains a significant challenge as the global community responds to the evolving mpox situation.
期刊介绍:
Drugs is a journal that aims to enhance pharmacotherapy by publishing review and original research articles on key aspects of clinical pharmacology and therapeutics. The journal includes:
Leading/current opinion articles providing an overview of contentious or emerging issues.
Definitive reviews of drugs and drug classes, and their place in disease management.
Therapy in Practice articles including recommendations for specific clinical situations.
High-quality, well designed, original clinical research.
Adis Drug Evaluations reviewing the properties and place in therapy of both newer and established drugs.
AdisInsight Reports summarising development at first global approval.
Moreover, the journal offers additional digital features such as animated abstracts, video abstracts, instructional videos, and podcasts to increase visibility and educational value. Plain language summaries accompany articles to assist readers with some knowledge of the field in understanding important medical advances.