There are currently no monkeypox-specific therapies to treat the infection. However, there are antiviral medications (and vaccinations) that may be used to prevent and treat monkeypox virus infections.
The FDA has approved two medications for the treatment of smallpox. Tecovirimat (TPOXX) is currently being recommended for some monkeypox patients. The drug, made by Siga Technologies, prevents mature viruses from being enveloped by targeting the viral VP37 protein. However, the drug has suffered from availability issues. In a statement on August 4, the company stated that we have received year to date, as of July 31, approximately $60 million of international orders from ten international jurisdictions.
Briccidofovir, a Chimerix oral antiviral, has been approved for the second time. However, a recent clinical investigation found that the drugs effectiveness against monkeypox was questioned.
monkeypox cases in the United States have surpassed 6,600 (25,800 worldwide) as of August 4, and the United States has declared monkeypox a public health emergency. In response, some researchers are looking for new antibiotics to treat monkeypox.
A group of researchers used a cell-based viral infection assay in a new (not yet peer-reviewed) study.
The research, conducted in Japan mainly at the National Institute of Infectious, employed a drug repurposing strategy. They sought to identify already-approved medications that might be effective against monkeypox. Three potential anti-monkeypox drugs were identified.
In the preprint titled, Potential anti-monkeypox virus activity of atovaquone, mefloquine, and molnupiravir, and their potential use as treatments, bioRxiv has published the findings.
The research started with a library of 132 clinically approved medications. monkeypox was first used in Vero E6 cells. After adding the compounds to be tested, they observed cytopathic effects 72 hours after infection.
Atovaquone is an antibiotic used to prevent and treat Pneumocystis jiroveci pneumonia (PCP). Molnupiravir is the third generation of anti-malarial drugs, Mefloquine, which is still used in several countries. The drugs' side effects, and a potential to cause permanent neurological and mental injuries, have been controversial.
In the teams infection assay, the three drugs significantly reduced the production of monkeypox proteins. In addition, the drugs activity was measured by quantifying viral DNA in infected cells following 30 hours of treatment (before the onset of monkeypox-induced cytopathic effects) with the drugs at varying concentrations.
Mefloquine (which inhibits mitochondrial electron transport and the pyrimidine biosynthesis pathway of parasites) and molnupiravir (a nucleoside analog that inhibits polymerization of the viral genome) were suggested to inhibit viral entry.
The team examined the various medicines in an effort to increase the anti-viral effect, and discovered that atovaquone coupled with tecovirimat enhanced the anti-monkeypox effect of tecovirimat.
The researchers hypothesized that atovaquone might improve viral clearance in patients by seven days, owing to quantitative mathematical simulations. Lastly, the researchers found that atovaquone and molnupiravir had pan-Orthopoxvirusactivity against vaccinia and cowpox viruses.
The authors noted that the study was limited in that it utilized only a cell culture infection assay. However, they added that, considering the limited amount of research concerning this virus to date and the current outbreak and spread of monkeypox across multiple continents, we believe that fast analyses using cell culture infection assays will be of benefit in providing scientific evidence to suggest alternative treatment solutions for this infectious illness and to minimize its international expansion.