The role of Tecovirmat (ST-246) as a potential antiviral agent against monkeypox infection : a systematic review

Abstract

INTRODUCTION: Since May 2022, the incidence of monkeypox caused by monkeypox virus (MPXV) has increased in several non-endemic countries such as United States, England, Singapore, and Indonesia. Until now, there is no definitive therapy for monkeypox. Tecovirimat is reported to have antiviral effects against MPXV.

OBJECTIVE: To determine the potensial activity of tecovirimat as an antiviral therapy against monkeypox infection.

METHODS: We followed the PRISMA guidelines to search literature through several databases: ProQuest, PubMed, EBSCOhost, SAGE, and Taylor&Francis from inception to May 20th, 2023. Titles and abstracts were reviewed to assess relevance. The inclusion criteria used were original articles, written in English, and assessed the activity of tecovirimat in monkeypox infection.

RESULTS AND DISCUSSION: From 558 studies, 15 studies that met the inclusion criteria were taken. There are studies in vitro (n=1), in vivo (n=8), case reports (n=2), case series (n=2), cross-sectional (n=1), and retrospective observational (n=1) published between 2009 and 2022. Tecovirimat was found to have 50% effective concentration of (EC50) <0.04 M against MPXV by reducing viral envelope production and shedding. A significant reduction [>1000-fold decrease (p<0.05)] in viral load was found in subjects treated with tecovirimat. Symptoms and skin lesions improved after administration of tecovirimat on days 2 to 3 with a dose of 600 mg, twice a day, for 14 consecutive days. The only reported side effects were mild headache and softer stool consistency.

CONCLUSION: Tecovirimat is an effective antiviral therapy and has no significant side effects in monkeypox infection.