As mpox continues Even as the virus spreads in Central Africa, a promising antiviral drug to treat the infection has failed to improve patients’ symptoms in a trial in the Democratic Republic of Congo, the epicenter of the outbreak.
In the trial, the drug tecovirimat, also known as TPOXX, did not alleviate the characteristic blister-like rash seen in people with mpox, formerly known as monkeypox. In an unusual move, the U.S. National Institute of Allergy and Infectious Diseases (NIAID), which sponsored the study, announced the initial results Earlier this month before the full results are peer-reviewed and published in a scientific journal.
Lori Dodd, chief of the NIAID’s division of clinical trials research and statistics, tells WIRED that the agency shared the initial results “because of the urgent need for scientific evidence on the use of tecovirimat for the treatment of mpox.” That urgency, she says, was reinforced by the World Health Organization designating the mpox outbreak in Central Africa as a global health emergency on August 14. This is the second such statement in two years.
The results are disappointing, especially as Central African countries are struggling to contain the transmission of the novel coronavirus pneumonia virus. Since the beginning of this year, 13 African countries have recorded a total of 20,720 confirmed or suspected cases of novel coronavirus pneumonia and 582 deaths, according to a WHO report. Report of August 25 from the Africa Centers for Disease Control and Prevention.
On Monday, the World Health Organization launched a six-month strategic plan The goal is to stop the outbreak. The plan, estimated to cost $135 million, includes strengthening surveillance measures as well as improving access to testing and vaccines. “The MPOX outbreaks in the Democratic Republic of the Congo and neighbouring countries can be controlled and stopped,” said Tedros Adhanom Ghebreyesus, director general of the WHO, in a statement.
There are approved vaccines to prevent MPOX but there are no medications indicated to treat the disease. Tecovirimat was Approved by the US Food and Drug Administration in 2018 for the treatment of smallpox, a related virus, and ongoing trials of the drug to treat mpox began in 2022 amid a global outbreak of the disease. The drug has also been available in the U.S. for mpox through an expanded access program, which allows a doctor to treat a patient with a investigational drug Outside of a clinical trial, TPOXX was approved for mpox in exceptional circumstances in the UK and Europe without comprehensive data on its efficacy.
As part of the trial in the Democratic Republic of Congo, nearly 600 participants were randomly assigned to receive either tecovirimat or a placebo and were admitted to a hospital for at least 14 days, where they were closely monitored. All participants received palliative care, including nutrition, hydration, and treatment for any secondary infections. While the drug was found to be safe, it was no better at healing patients’ lesions than the placebo.
Notably, mortality was lower and patients’ lesions disappeared more quickly than expected, regardless of whether they received tecovirimat or placebo. The overall mortality of 1.7 percent among study participants, regardless of whether they received the drug or not, was much lower than the mortality of 3.6 percent or more recorded among all cases in the Democratic Republic of the Congo.
