A group of researchers at the University of Oxford are investigating the therapeutic potential of an antiviral called tecovirimat against monkeypox. The PLATINUM team states that it is a “UK-wide clinical trial” hoping to shorten the time that people are infectious with monkeypox and enable faster recovery.
What is Tecovirimat?
Tecovirimat, or Tpoxx, is an antiviral drug, developed to treat illnesses caused by poxviruses including monkeypox. It restricts the virus’ movement from infected cells, limiting its spread throughout the body. According to the PLATINUM team it has been “shown to improve recovery” in animals but until now very few opportunities have presented themselves for investigation of the effects in humans. However, PLATINUM emphasises that it has been tested on over 400 healthy people to demonstrate its safety.
In the US it was approved for the treatment of smallpox disease under the “Animal Rule”. This facilitates the approval of drugs for emergencies when it is “not ethical to conduct efficacy studies” and “not feasible to conduct field trials”. Efficacy is determined based on “adequate and well-controlled” animal studies. It was licensed earlier in 2022 for use against monkeypox.
How will the trial work?
The trial involves patients with “mild monkeypox disease”, including children. The participants will be divided into two groups, one of which will receive tecovirimat. The other group will take an “identical looking placebo drug”. The course of taking these drugs continues for 14 days. All patients will “still receive the standard care from the NHS” and are free to cease participation if they wish.
The researchers will compare how quickly symptoms, specifically skin lesions, improve. This will be monitored by self-assessment through an online form. Furthermore, the rate at which patients can clear the virus from their system will be measured through swabs. Around 500 patients will be included.
As monkeypox cases are reported across non-endemic countries, researchers are scrambling to find solutions to reduce the consequences and chances of infection. Monkeypox was declared a PHEIC by WHO in July 2022.
Professor Sir Peter Horby, one of the lead researchers, stated that “the aim is to find a treatment that can help people get better quicker and get out of quarantine.” Thus, once the efficacy of this drug has been determined, it will be important to look ahead to wider distribution to ensure that endemic countries are able to provide patients with relief and recovery.
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