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Compassionate Use of Tecovirimat for the Treatment of Monkeypox Infection

To identify the key insights or developments described in this article

Monkeypox is a zoonotic orthopoxvirus in the same genus as variola (the causative agent of smallpox).1 A recent global outbreak has led to more than 39 000 cases reported as of August 18, 2022.2 Monkeypox is typically self-limited with symptoms generally lasting between 2 and 4 weeks in prior outbreaks. Hospitalization was required in 13% of patients in a recent study, suggesting the need for effective therapy.3

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Article Information

Accepted for Publication: August 17, 2022.

Published Online: August 22, 2022. doi:10.1001/jama.2022.15336

Corresponding Author: Angel Desai, MD, MPH, Division of Infectious Diseases, University of California Davis Medical Center, 4150 V St, Sacramento, CA 95816 (andesai@ucdavis.edu).

Author Contributions: Drs Desai and Thompson had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Desai, Thompson, Cohen.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Desai, Thompson, Neumeister, Arutyunova.

Critical revision of the manuscript for important intellectual content: Desai, Thompson, Trigg, Cohen.

Statistical analysis: Thompson.

Administrative, technical, or material support: Thompson, Neumeister, Arutyunova, Trigg, Cohen.

Supervision: Thompson, Trigg, Cohen

Conflict of Interest Disclosures: None reported.

Disclaimer: Dr Desai is an Associate Editor for JAMA Network Open. She had no role in the review of this submission or the decision to accept for publication.

Additional Contributions: We thank Olivia Kasirye, MD, Sacramento County Department of Public Health, and surrounding counties and health departments for their assistance in rapid diagnosis and treatment of our patients. Dr Kasiyre received no compensation.

References
1.
Adler  H , Gould  S , Hine  P ,  et al; NHS England High Consequence Infectious Diseases (Airborne) Network.  Clinical features and management of human monkeypox: a retrospective observational study in the UK.   Lancet Infect Dis. 2022;22(8):1153-1162. doi:10.1016/S1473-3099(22)00228-6PubMedGoogle ScholarCrossref
2.
CDC. 2022 Monkeypox outbreak global map. July 27, 2022. Accessed July 28, 2022. https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
3.
Thornhill  JP , Barkati  S , Walmsley  S ,  et al; SHARE-net Clinical Group.  Monkeypox virus infection in humans across 16 countries—April-June 2022.   N Engl J Med. Published online July 21, 2022. doi:10.1056/NEJMoa2207323PubMedGoogle ScholarCrossref
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 Virol. 2005;79(20):13139-13149. doi:10.1128/JVI.79.20.13139-13149.2005PubMedGoogle ScholarCrossref
5.
Grosenbach  DW , Honeychurch  K , Rose  EA ,  et al.  Oral tecovirimat for the treatment of smallpox.   N Engl J Med. 2018;379(1):44-53. doi:10.1056/NEJMoa1705688PubMedGoogle ScholarCrossref
6.
CDC. Information for healthcare providers on obtaining and using TPOXX (tecovirimat) for treatment of monkeypox. August 9, 2022. Accessed August 15, 2022. https://www.cdc.gov/poxvirus/monkeypox/clinicians/obtaining-tecovirimat.html
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