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Effect of tecovirimat on healing time and viral clearance by emulation of a target trial in patients hospitalized for mpox

Mazzotta, V; Cozzi-Lepri, A; Lanini, S; Mondi, A; Carletti, F; Tavelli, A; Gagliardini, R; ... Antinori, A; + view all (2023) Effect of tecovirimat on healing time and viral clearance by emulation of a target trial in patients hospitalized for mpox. Journal of medical virology , 95 (6) , Article e28868. 10.1002/jmv.28868. Green open access

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Abstract

Tecovirimat is a treatment option for severe mpox, although randomized clinical trials are ongoing. The aim of the study is to assess the effect of tecovirimat on healing time and the extent of viral clearance by target trial emulation using observational data. Clinical and virological data of patients hospitalized for mpox were collected. Samples from the upper respiratory tract (URT) were grouped in two time points: T1 (median 6 days from symptoms onset) and T2 (median 5 days from T1). Patients were followed-up until recovery. Average treatment effect (ATE) in patients untreated versus treated with tecovirimat was estimated on time to healing and variation in viral load in URT, using a weighted and cloning analysis. Among the 41 patients included, 19 completed a course of tecovirimat. The median time from symptoms onset to hospitalization and to drug-starting was 4 days and 10 days, respectively. No improvement in healing time in treated versus untreated was observed. No difference by treatment group in time to viral clearance was detected by ATE fitted in a subset of 13 patients after controlling for confounders. We found no evidence for a large effect of tecovirimat in shortening healing time and viral clearance. While awaiting the results of randomized studies, the use of tecovirimat should be restricted to the clinical trial setting.

Type: Article
Title: Effect of tecovirimat on healing time and viral clearance by emulation of a target trial in patients hospitalized for mpox
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/jmv.28868
Publisher version: https://doi.org/10.1002/jmv.28868
Language: English
Additional information: © 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Keywords: healing, mpox, tecovirimat, therapy, viral clearance, Humans, Benzamides, Hospitalization, Isoindoles, Monkeypox
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10172481
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