Recent research of antiviral drugs and vaccines for Mpox

doi:10.19803/j.1672-8629.20230690

Abstract

Abstract: Monkeypox (Mpox) is a disease caused by infection with the monkeypox virus (MPXV). There is no specific therapeutic drug for monkeypox virus in the world, and antiviral drugs and vaccines are primarily used for the treatment and prevention of smallpox and other orthopoxviral diseases. The antiviral drugs mainly include Teicovirimat, Cidofovir, Brincidofovir, while vaccines mainly use ACAM2000, MVA-BN, and LC16, which have shown effectiveness in treating and preventing Mpox. Currently, Given the absence of a specific drug and a more effective and safer vaccine, these drugs and vaccines can be used in early treatment and prevention to alleviate clinical symptoms caused by the monkeypox virus, reducing the rate of severe disease and mortality. The thesis was discussed in terms of antiviral drugs and vaccines mechanism of action, clinical trials and safety to study the antiviral drugs and vaccines currently used internationally for the treatment of Mpox, with a view to providing reference for the treatment and prevention of Mpox in China.

Key words: mpox, monkeypox virus, smallpox, antiviral drugs, vaccine

CLC Number:

R978

GAO Xu, PENG Jin’e, LI Xingwang, ZHANG Wei. Recent research of antiviral drugs and vaccines for Mpox[J]. Chinese Journal of Pharmacovigilance, 2024, 21(1): 111-116.

Add to citation manager EndNote|Ris|BibTeX

URL: https://www.zgywjj.com/EN/10.19803/j.1672-8629.20230690

https://www.zgywjj.com/EN/Y2024/V21/I1/111

References

[1] WHO. WHO Director-General's opening remarks at the media briefing-25 August 2023[EB/OL].(2023-08-25)[2023-10-18]. https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing---25-august-2023.
[2] National Health Commission. Announcement of the National Health Commission[EB/OL].(2023-09-15)[2023-10-18]. http://www.nhc.gov.cn/ylyjs/pqt/202309/3680634893d341e1b933726c206c20f6.shtml.
[3] WHO. Clinical management and infection prevention and control for monkeypox: Interim rapid response guidance, 10 June2022[EB/OL].(2022-06-10)[2023-10-18]. https://www.who.int/publications/i/item/WHO-MPX-Clinical-and-IPC-2022.1.
[4] YANG G, PEVEAR DC, DAVIES MH, et al.An orally bioavailable antipoxvirus compound(ST-246) inhibits extracellular virus formation and protects mice from lethal orthopoxvirus Challenge[J]. J Virol, 2005, 79(20): 13139-13149.
[5] RUSSO AT, GROSENBACH DW, CHINSANGARAM J, et al.An overview of tecovirimat for smallpox treatment and expanded anti-orthopoxvirus applications[J]. Expert Review of Anti-infective Therapy, 2021, 19(3): 331-344.
[6] FDA. FDA approves the first drug with an indication for treatment of smallpox[EB/OL].(2018-07-13)[2023-10-18]. https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-indication-treatment-smallpox.
[7] EMA. Tecovirimat SIGA[EB/OL].(2022-01-28)[2023-10-18]. https://www.ema.europa.eu/en/medicines/human/EPAR/tecovirimat-siga.
[8] CDC. Guidance for Tecovirimat Use[EB/OL].(2023-06-07)[2023-10-18]. https://www.cdc.gov/poxvirus/mpox/clinicians/Tecovirimat.html.
[9] BERHANU A, PRIGGE JT, SILVERA PM, et al.Treatment with the smallpox antiviral tecovirimat(ST-246) alone or in combination with ACAM2000 vaccination is effective as a postsymptomatic therapy for monkeypox virus infection[J]. Antimicrobial Agents and Chemotherapy, 2015, 59(7): 4296-4300.
[10] DESAI AN, THOMPSON GR, NEUMEISTER SM, et al.Compassionate use of tecovirimat for the treatment of monkeypox infection[J]. Jama, 2022, 328(13): 1348-1350.
[11] ADLER H, GOULD S, HINE P, et al.Clinical features and management of human monkeypox: a retrospective observational study in the UK[J]. The Lancet Infectious Diseases, 2022, 22(8): 1153-1162.
[12] HERNANDEZ LE, JADOO A, KIRSNER RS.Human monkeypox virus infection in an immunocompromised man: trial with tecovirimat[J]. Lancet, 2022, 400(10355): e8.
[13] FDA. Instructions for Tecovinimat[EB/OL].(2022-05-18)[2023-10-18]. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/208627s007lbl.pdf.
[14] ANDREI G, SNOECK R.Cidofovir activity against poxvirus infections[J]. Viruses, 2010, 2(12): 2803-2830.
[15] KHANI E, AFSHARIRAD B, ENTEZARI-MALEKI T.Monkeypox treatment: Current evidence and future perspectives[J]. Journal of medical virology, 2023, 95(1): e28229.
[16] DE CLERCQ E.Clinical potential of the acyclic nucleoside phosphonates cidofovir, adefovir, and tenofovir in treatment of DNA virus and retrovirus infections[J]. Clinical Microbiology Reviews, 2003, 16(4): 569-596.
[17] CDC. Treatment Information for Healthcare Professionals[EB/OL].(2023-07-10)[2023-10-18]. https://www.cdc.gov/poxvirus/mpox/clinicians/treatment.html.
[18] WACHSMAN M, PETTY BG, CUNDY KC, et al.Pharmacokinetics, safety and bioavailability of HPMPC(cidofovir) in human immunodeficiency virus-infected subjects[J]. Antiviral Research, 1996, 29(2-3): 153-161.
[19] STITTELAAR K J, NEYTS J, NAESENS L, et al.Antiviral treatment is more effective than smallpox vaccination upon lethal monkeypox virus infection[J]. Nature, 2006, 439(7077): 745-748.
[20] MOSCHESE D, GIACOMELLI A, BELTRAMI M, et al.Hospitalisation for monkeypox in Milan, Italy[J]. Travel Medicine and infectious disease, 2022, 49: 102417.
[21] SOBRAL-COSTAS T G, ESCUDERO-TORNERO R, SERVERA-NEGRE G, et al. Human monkeypox outbreak: epidemiological data and therapeutic potential of topical cidofovir in a prospective cohort study[J]. Journal of the American Academy of Dermatology, 2023, 88(5): 1074-1082.
[22] MARTÍNEZ-FERNÁNDEZ DE, FERNÁNDEZ-QUEZADA D, CASILLAS-MUÑOZ FAG, et al. Human monkeypox: a comprehensive overview of epidemiology, pathogenesis, diagnosis, treatment, and prevention strategies[J]. Pathogens, 2023, 12(7): 947.
[23] SCIENCE.INC G.Vistide[EB/OL].[2023-10-18].https://www.gilead.com/~/media/Files/pdfs/medicines/other/vistide/vistide.pdf.
[24] CHEN LS.Cidofovir, a new cytomegalovirus drug[J]. Overseas Pharmaceuticals(Synthetic, Biochemical and Pharmaceutical Preparations)(国外医药合成药生化药制剂分册), 1998(1): 28-31.
[25] SIEGRIST E A, SASSINE J.Antivirals with activity against mpox: a clinically oriented review[J]. Clinical Infectious Diseases, 2023, 76(1): 155-164.
[26] HOSTETLER KY.Alkoxyalkyl prodrugs of acyclic nucleoside phosphonates enhance oral antiviral activity and reduce toxicity: current state of the art[J]. Antiviral Research, 2009, 82(2): A84-A98.
[27] LANIER R, TROST L, TIPPIN T, et al.Development of CMX001 for the treatment of poxvirus infections[J]. Viruses, 2010, 2(12): 2740-2762.
[28] FDA. FDA approves drug to treat smallpox[EB/OL].(2021-06-04)[2023-10-18]. https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/fda-mpox-response.
[29] HUTSON CL, KONDAS AV, MAULDIN MR, et al.Pharmacokinetics and efficacy of a potential smallpox therapeutic, brincidofovir, in a lethal monkeypox virus animal model[J]. mSphere, 2021, 6(1): e00927-20.
[30] FDA. Instructions for Brincidofovir[EB/OL].(2021-08-03)[2023-10-18]. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/214460s001,214461s001lbl.pdf
[31] DE LA CALLE-PRIETO F, ESTÉBANEZ MUÑOZ M, RAMÍREZ G, et al. Treatment and prevention of monkeypox[J]. Enferm Infec Microbiol Clin(English ed), 2023, 41(10): 629-634.
[32] DELAUNE D, ISENI F. drug development against smallpox: present and future[J]. Antimicrobial Agents and Chemotherapy, 2020, 64(4): e01683-19.
[33] SERGEEV AA, KABANOV AS, BULYCHEV LE, et al.The possibility of using the icr mouse as an animal model to assess antimonkeypox drug efficacg Transbouncl[J]. Transboundary and Emerging Diseases, 2016, 63(5): e419-e430.
[34] MAZURKOV OY, SHISHKINA LN, BORMOTOV NI, et al.Estimation of absolute bioavailability of the chemical substance of the anti-smallpox preparation NIOCH-14 in mice[J]. Bulletin of Experimental Biology and Medicine, 2020, 170(2): 207-210.
[35] MAZURKOV OY, KABANOV AS, SHISHKINA LN, et al.New effective chemically synthesized anti-smallpox compound NIOCH-14[J]. Journal of General Virology, 2016, 97(5): 1229-1239.
[36] RIZK JG, LIPPI G, HENRY BM, et al.Prevention and treatment of monkeypox[J]. Drugs, 2022, 82(9): 957-963.
[37] WHO. Vaccines and immunization for monkeypox: interim guidance[EB/OL].(2022-11-16)[2023-10-18]. https://www.who.int/publications/i/item/WHO-MPX-Immunization.
[38] BROWN K, LEGGAT PA.Human monkeypox: current state of knowledge and implications for the future[J]. Tropical Medicine and Infectious Disease, 2016, 1(1):8.
[39] ABDELAAL A, REDA A, LASHIN BI, et al.Preventing the next pandemic: Is live vaccine efficacious against monkeypox, or is there a need for killed virus and mRNA vaccines?[J]. Vaccine, 2022, 10(9): 1419.
[40] MARRIOTT KA, PARKINSON CV, MOREFIELD SI, et al.Clonal vaccinia virus grown in cell culture fully protects monkeys from lethal monkeypox challenge[J]. Vaccine, 2008, 26(4): 581-588.
[41] TURNER M, MANDIA J, KELTNER C, et al.Monkeypox in patient immunized with ACAM2000 smallpox vaccine during 2022 outbreak[J]. Emerging Infectious Diseases, 2022, 28(11): 2336-2338.
[42] KATAMESH BE, MADANY M, LABIEB F, et al.Monkeypox pandemic containment: does the ACAM2000 vaccine play a role in the current outbreaks?[J]. Expert Review of Vaccines, 2023, 22(1): 366-368.
[43] MEO SA, AL-MASRI AA, KLONOFF DC, et al.Comparison of biological, pharmacological characteristics, indications, contraindications and adverse effects of JYNNEOS and ACAM2000 monkeypox vaccines[J]. Vaccine, 2022, 10(11): 1971.
[44] CDC. Contraindications to vaccination[EB/OL].(2016-12-05)[2023-10-18]. https://www.cdc.gov/smallpox/clinicians/vaccination-contraindications1.html.
[45] MBALA PK, HUGGINS JW, RIU-ROVIRA T, et al.Maternal and fetal outcomes among pregnant women with human monkeypox infection in the democratic republic of congo[J]. The Journal of infectious diseases, 2017, 216(7): 824-828.
[46] GOV.UK. Guidance-monkeypox vaccination recommendations[EB/OL].(2022-08-26)[2023-10-18]. https://www.gov.uk/government/publications/monkeypox-vaccination.
[47] RAO AK, PETERSEN BW, WHITEHILL F, et al.Use of JYNNEOS(smallpox and monkeypox vaccine, live, nonreplicating) for preexposure vaccination of persons at risk for occupational exposure to orthopoxviruses: recommendations of the advisory committee on immunization practices - United States, 2022[J]. Morbidity and Mortality Weekly Report, 2022, 71(22): 734-742.
[48] KECKLER MS, SALZER JS, PATEL N, et al.IMVAMUNE^(®) and ACAM2000(®) provide different protection against disease when administered postexposure in an intranasal monkeypox challenge prairie dog model[J]. Vaccines, 2020, 8(3): 396.
[49] WOLFF SY, ZUCKER R, HAMMERMAN A, et al.Real-world effectiveness of a single dose of mpox vaccine in males[J]. Nature Medicine, 2023, 29(3): 748-752.
[50] DEPUTY NP, DECKERT J, CHARD AN, et al.Vaccine Effectiveness of JYNNEOS against mpox disease in the United States[J]. The New England Journal of Medicine, 2023, 388(26): 2434-2443.
[51] HATCH GJ, GRAHAM VA, BEWLEY KR, et al.Assessment of the protective effect of imvamune and acam2000 vaccines against aerosolized monkeypox virus in cynomolgus macaques[J]. J Virol, 2013, 87(14): 7805-7815.
[52] TAKAHASHI-NISHIMAKI F, SUZUKI K, MORITA M, et al.Genetic analysis of vaccinia virus lister strain and its attenuated mutant LC16m8: production of intermediate variants by homologous recombination[J]. Journal of General Virology, 1987, 68( Pt 10): 2705-2710.
[53] SAIJO M, AMI Y, SUZAKI Y, et al.Diagnosis and assessment of monkeypox virus(MPXV) infection by quantitative PCR assay: differentiation of Congo Basin and West African MPXV strains[J]. Japanese Journal of Infectious Diseases, 2008, 61(2): 140-142.
[54] IIZUKA I, AMI Y, SUZAKI Y, et al.A single vaccination of nonhuman primates with highly attenuated smallpox vaccine, LC16m8, provides long-term protection against monkeypox[J]. Japanese Journal of Infectious Diseases, 2017, 70(4): 408-415.
[55] TOMITA N, TERADA-HIRASHIMA J, UEMURA Y, et al.An open-label, non-randomized study investigating the safety and efficacy of smallpox vaccine, LC16, as post-exposure prophylaxis for MPOX[J]. Human Vaccines & Immunotherapeutics, 2023, 19(2): 2242219.