Antivirals With Activity Against Monkeypox: A Clinically Oriented Review

Monkeypox virus is an emerging human pathogen. This review discusses the basic pharmacology, animal data, and human data for 3 antivirals with activity against monkeypox: cidofovir, brincidofovir, and tecovirimat. Monkeypox virus is an emergent human pathogen. While it is less lethal than smallpox, it can still cause significant morbidity and mortality. In this review, we explore 3 antiviral agents with activity against monkeypox and other orthopoxviruses: cidofovir, brincidofovir, and tecovirimat. Cidofovir, and its prodrug brincidofovir, are inhibitors of DNA replication with a broad spectrum of activity against multiple families of double-stranded DNA viruses. Tecovirimat has more specific activity against orthopoxviruses and inhibits the formation of the extracellular enveloped virus necessary for cell-to-cell transmission. For each agent, we review basic pharmacology, data from animal models, and reported experience in human patients.

Automated summary

This review provides an overview of the basic pharmacology, animal data, and human data for three antivirals (cidofovir, brincidofovir, and tecovirimat) with activity against monkeypox virus. These antiviral agents have shown varying degrees of efficacy against monkeypox and other orthopoxviruses, highlighting their potential importance in the research and treatment of monkeypox virus infection.