Topical cidofovir 1% may have utility in mpox lesions
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Topical cidofovir 1% was associated with rapid improvement of lesions in a cohort of patients with mpox, according to a study.
“Given the rapid spread of the current outbreak ... we prioritized the search for treatments that could shorten infectivity time (and therefore, the isolation period) and reduce potential cosmetic damage,” Tristán Gabriel Sobral-Costas, MD, of the dermatology department at La Paz University Hospital in Spain, and colleagues wrote.
The researchers noted that cidofovir (Vistide, Gilead Sciences) has shown efficacy against vaccinia and other orthopoxvirus diseases. With this in mind, the group hypothesized that topical cidofovir may have utility in treating skin lesions resulting from mpox — WHO’s updated name for monkeypox disease — without the adverse impacts associated with the systemic formulation.
The prospective trial included 24 patients aged 18 years or older who had at least one mpox lesion. Clinicians assigned 12 patients to receive cidofovir 1% and the other 12 to only receive symptomatic treatment, according to the findings.
Patients treated with cidofovir experienced more rapid clearing of lesions (HR = 4.572; P = .0039).
The median time to resolution was 12 days (range, 11.5-15) in the cidofovir arm and 18 days (range, 16-21) in the symptomatic treatment arm.
By day 15, the researchers observed PCR-positive skin lesions in 10% of patients treated with cidofovir and 62.5% of those not treated with this drug (P = .019).
While no systemic adverse events were reported, 50% of patients experienced local adverse events. These were seen most commonly in the anogenital region.
The researchers noted that the lack of placebo-controlled arm may limit the applicability of the findings.
“Topical cidofovir is a potentially relevant therapy in patients with skin lesions but mild systemic involvement,” the researchers concluded. “Reducing time to resolution could shorten isolation time and improve the cosmetic impact in areas such as the face.”