Tembexa (brincidofovir oral) / SymBio Pharma, Jazz - LARVOL DELTA

Lack of Resistance Development during Brincidofovir Therapy in Animal Models of Orthopoxvirus Infection. (PubMed, Antiviral Res) - "No previously identified viral DNA polymerase BCV or cidofovir RAS were detected at or above 1% frequency in the RPXV or ECTV samples by NGS. Several novel mutations were identified in mouse ECTV samples; however, none, when introduced into VACV, conferred BCV resistance in a plaque reduction assay. In conclusion, no BCV resistance-associated mutations were detected in either animal model under the conditions of this treatment regimen."

Journal • Preclinical • Infectious Disease

Lactoferrin blocks orthopoxvirus entry via heparan sulphate and regulates host antiviral pathways. (PubMed, Emerg Microbes Infect) - "Combination administration of lactoferrin with brincidofovir or tecovirimat demonstrated additive efficacy, suggesting a potential clinical strategy to reduce individual drug toxicity. These results underscore lactoferrin's distinctive dual antiviral mechanism and highlight its translational potential as a safe and cost-effective prophylactic or therapeutic agent. It is particularly beneficial for immunocompromised populations in resource-limited settings during orthopoxvirus outbreaks."

Journal • Infectious Disease • TGFB1 • TGFBI

The evolving mpox threat (2022-2024): clade dynamics, immune evasion, and escalating global health challenges. (PubMed, Front Cell Infect Microbiol) - "We evaluate current diagnostic standards, such as PCR, alongside emerging techniques, and assess the efficacy of antiviral therapies, including tecovirimat, brincidofovir, and cidofovir. The status of vaccination, from second-generation (ACAM2000) to third-generation (MVA-BN and LC16m8) platforms, is critically appraised for its role in outbreak control. Furthermore, we explore the successes and hurdles of public health strategies, including surveillance, contact tracing, and community engagement, in managing stigma and ensuring equity. The review concludes by outlining future perspectives, emphasizing the urgent need for enhanced surveillance, accessible countermeasures, and research into broad-spectrum antivirals and vaccines to prepare for the ongoing threat of MPXV."

Journal • Review

Monkeypox Infection In Kidney Transplant Recipients： A Narrative Review. (PubMed, Kidney Blood Press Res) - "Monkeypox infection is spreading fast over the world and presents a major concern to kidney transplant recipients. In this immunocompromised group, we should focus more on effective preventative and treatment techniques. Further research is needed to standardize management algorithms."

Journal • Review • Infectious Disease • Pain • Pulmonary Disease • Transplantation

Insights into Monkeypox Virus: Host Immunity, Viral Immune Evasion, Recent Advances in Vaccines, Therapeutic Development, and Future Perspectives. (PubMed, Microorganisms) - "Alternative drugs like tecovirimat and brincidofovir have demonstrated potential for treating smallpox, but there is scanty evidence on their efficacy against MPXV. Most recent advancements in the study of vaccines have resulted in the creation and introduction of MVA-BN (JYNNEOS/Imvanex/Imvamune) and ACAM2000 vaccines, which conferred cross-protection against MPXV...The discovery of novel vaccine candidates and antiviral treatments will be needed to prevent future outbreaks and reduce the global health burden of Mpox. This review focuses on the characterization of MPXV, summarizing current knowledge on its genomic structure, pathogenesis, replication, potential targets of anti-MPXV drugs, clinical features, and epidemiological patterns, along with recent advances in vaccine development."

Journal • Review • Infectious Disease • Novel Coronavirus Disease

Pathogenicity and antiviral treatment of Clade Ib Monkeypox virus infection in mice. (PubMed, Antiviral Res) - "Here we describe the development of a lethal mouse model for clade Ib MPXV infection and its successful treatment using approved antivirals. Our results suggest that tecovirimat, cidofovir and brincidofovir remain suitable therapeutic options to treat clade Ib MPXV infection."

Journal • Preclinical • Infectious Disease

Eculizumab Is Associated with Significantly Lower Adenovirus Clearance in Children after Hematopoietic Cell Transplantation (TCT-ASTCT-CIBMTR 2026) - " Among 25 children with adenoviremia, the first adenovirus PCR was detected a median of 62 days post-HCT, Treatment approaches included cidofovir (76%), reduction of immune suppression (32%), viral specific T cells (20%), and brincidofovir (8%)- all ecu exposed patients received ≥1 treatment and 50% of non-ecu exposed received ≥1 treatment...In bivariable models adjusting for alemtuzumab (HR 0.26, p=0.02), abatacept (HR 0.14, p=0.001), post-HCT cyclophosphamide (HR 0.28, p=0.02), grade 3-4 acute GVHD (HR 0.20, p=0.02), and absolute lymphocyte count at first adenovirus PCR (HR 0.29, p=0.02), adenovirus clearance remained significantly lower in than those exposed to ecu... In this single center retrospective study, eculizumab exposed children were 3 times less likely to clear adenovirus and 6 times more likely to die of adenovirus related mortality. While these findings need to be validated in larger cohorts, our findings merit a careful risk/benefit analysis prior to..."

Clinical • Acute Graft versus Host Disease • Graft versus Host Disease • Immunology • Infectious Disease • Transplantation • Transplantation Associated Thrombotic Microangiopathy

Preclinical activity of brincidofovir in peripheral T-cell and NK/T-cell lymphoma. (PubMed, BMC Med) - "Taken together, these results demonstrate a novel role for BCV in lymphoma therapy and suggest potential for combination with checkpoint immunotherapy."

IO biomarker • Journal • Preclinical • B Cell Lymphoma • Hematological Malignancies • Lymphoma • Natural Killer/T-cell Lymphoma • Non-Hodgkin’s Lymphoma • Oncology • T Cell Non-Hodgkin Lymphoma • PD-L1

Assessment of three antiviral compounds against Borealpox virus infection in a mouse model. (PubMed, Emerg Microbes Infect) - "Notably, extensive fluid retention was also observed in these mice. Further assessment of cidofovir, brincidofovir, and tecovirimat therapy against BRPV infection demonstrated that all three compounds resulted in improved clinical condition and significant reductions in BRPV titers."

Journal • Preclinical • Infectious Disease

The Emerging Threat of Monkeypox: An Updated Overview. (PubMed, Viruses) - "Therapeutic options remain limited; supportive care is the cornerstone of management, but antivirals such as tecovirimat and brincidofovir, as well as smallpox vaccines, have shown efficacy in mitigating disease severity and preventing infection. We also discuss the role of animal reservoirs, viral evolution, and human-to-human transmission in shaping the dynamics of recent MPOX outbreaks. By summarizing the latest evidence, this review aims to inform clinicians, researchers, and policymakers about key aspects of MPOX biology, clinical management, and prevention, while identifying gaps that warrant future investigation for the control of this and potentially other emerging zoonotic-related pathogens with an impact on human health."

Journal • Review • Infectious Disease • Varicella Zoster

Maternal-Fetal Implications of Mpox Infection: Current Evidence. (PubMed, J Clin Med) - "Data regarding therapeutic safety in pregnancy are limited; however, tecovirimat appears to have the most favorable profile, whereas cidofovir and brincidofovir remain contraindicated. Given the evolving epidemiological profile, the potential for vertical transmission, and the risk of adverse perinatal outcomes, Mpox infection during pregnancy poses unique clinical challenges. This review synthesizes current evidence on virology, clinical presentation, diagnosis, prevention, and management, with an emphasis on obstetric considerations and public health implications."

Journal • Review • Infectious Disease • Obstetrics

Mpox therapeutics in the post-STOMP/PALM era. (PubMed, Curr Opin HIV AIDS) - "This article summarizes the evidence behind current treatment recommendations including tecovirimat, brincidofovir, cidofovir, trifluridine, and VIGIV, as well as other investigational treatments."

Journal

Exploration of the protein and pharmacological landscape of monkeypox virus treatment: from entry point to end point. (PubMed, Mol Divers) - "Current therapeutics, such as tecovirimat (targeting VP37 to block egress), brincidofovir, and cidofovir (inhibiting DNA polymerase E9L), offer symptomatic relief but face hurdles like resistance mutations (e.g., A314V in E9L) and suboptimal efficacy in immunocompromised patients...Computational approaches integrating AI-driven screening, molecular dynamics simulations, and multi-omics have pinpointed repurposed candidates like lumacaftor and conivaptan as VP37 inhibitors. This integrative framework advocates for combination therapies, personalized regimens based on clade profiling, and global collaboration to mitigate MPXV's adaptive potential. By bridging virology and pharmacology, the review charts pathways for innovative drug development to combat this zoonotic threat effectively."

IO biomarker • Journal • Review • Infectious Disease

In vivo characterization of preclinical efficacy of brincidofovir against glioblastoma (SNO 2025) - "Brincidofovir (BCV) is lipid-conjugated cidofovir characterized by a lack of nephrotoxicity and superior activity compared to cidofovir...In the combination study, mice were administered temozolomide 2 mg/kg p.o. (TMZ) once daily for 5 days, whole brain radiotherapy (WBRT) of 1.5 Gy for 5 days plus TMZ, or bevacizumab 5 mg/kg i.p. BIW alone or concomitant with BCV 10 mg/kg... BCV monotherapy suppressed tumor growth and prolonged survival in PDX models of GBM and improved the efficacy of the standard of care for GBM."

Preclinical • Brain Cancer • Glioblastoma • Solid Tumor

Synergistic antiviral activity against human adenovirus through combination of itraconazole and brincidofovir. (PubMed, Br J Pharmacol) - "Given the gastrointestinal toxicity associated with brincidofovir, its combination with the host-directed drug itraconazole allowed lower brincidofovir doses to be used to decrease HAdV titres, thereby minimizing adverse drug effects while maintaining antiviral efficacy."

Journal • Gastroenterology • Gastrointestinal Disorder • Infectious Disease

Broad-spectrum antiviral brincidofovir inhibits Epstein-Barr virus and related gammaherpesvirus in human and nonhuman primate cells. (PubMed, J Clin Invest) - "These results suggest that BCV may be a useful antiviral for inhibiting EBV activity in MS patients. Additionally, this work further validates the utility of CalHV-3 in marmosets as a translational model for the investigation of successful EBV-targeting therapeutics."

Journal • CNS Disorders • Epstein-Barr Virus Infections • Multiple Sclerosis

Battle won, war ongoing: A call for mpox vaccination in high-risk dermatologic cases. (PubMed, JAAD Case Rep) - No abstract available

Journal

Lipid-Optimized Sulfone-Bridged Cidofovir Prodrugs as Potent Antivirals Against Orthopoxviruses. (PubMed, J Med Chem) - "Compound 13f exhibited antiviral activity against vaccinia virus (VACV) comparable to that of the reference brincidofovir (BCV), while 13i displayed 8.2-fold enhanced potency. Notably, 13i exhibited a favorable safety profile and significant therapeutic efficacy in both VACV-challenged BALB/c and MPXV-challenged severe combined immunodeficiency mouse models. Through systematic lipid-chain optimization, we identified 13i as a promising antiviral candidate with enhanced efficacy and favorable pharmaceutical properties."

Journal • Genetic Disorders • Immunology • Infectious Disease • Primary Immunodeficiency

In vivo characterization of preclinical efficacy of brincidofovir against glioblastoma (WFNOS 2025) - "Brincidofovir (BCV) is lipid-conjugated cidofovir characterized by a lack of nephrotoxicity and superior activity compared to cidofovir...In the combination study, mice were administered temozolomide 2 mg/kg p.o. (TMZ) once daily for 5 days, whole brain radiotherapy (WBRT) of 1.5 Gy for 5 days plus TMZ, or bevacizumab 5 mg/kg i.p. BIW alone or concomitant with BCV 10 mg/kg... BCV monotherapy suppressed tumor growth and prolonged survival in PDX models of GBM and improved the efficacy of the standard of care for GBM."

Preclinical • Brain Cancer • Glioblastoma • Solid Tumor

Disseminated Mpox Infection in a Vaccinated Kidney Transplant Recipient (KIDNEY WEEK 2025) - "He was on a belatacept-based immunosuppressive regimen and has received Jynneos approximately two years prior to symptom onset...Given the severity of his lesions, he was treated with IV tecovirimat, vaccinia immune globulin (VIVIg), brincidofovir and topical cidofovir...Additional studies are needed to assess the effectiveness of these vaccines in immunocompromised patients. Figure 1: Perioral lesions before treatment (A) and after treatment ~2 months later (B), abdomen (C), right hand (D), and back lesions with typical desquamation (E)"

Clinical • Chronic Kidney Disease • Human Immunodeficiency Virus • Infectious Disease • Renal Disease • Transplantation

Therapeutic Repurposing of Brincidofovir in Non-Hodgkin Lymphoma – Potential Synergy with Immune Checkpoint Blockade (ASH 2024) - "Conclusions : Taken together, these results demonstrate a novel role of BCV in the treatment of lymphoma. The immunogenic effects of BCV suggests potential for combination with PD1/PDL1 and CTLA4 checkpoint immunotherapy."

Checkpoint block • Checkpoint inhibition • IO biomarker • B Cell Lymphoma • B Cell Non-Hodgkin Lymphoma • Diffuse Large B Cell Lymphoma • Hematological Malignancies • Lymphoma • Natural Killer/T-cell Lymphoma • Non-Hodgkin’s Lymphoma • Oncology • Peripheral T-cell Lymphoma • T Cell Non-Hodgkin Lymphoma • BCL2 • CCL2 • CXCL9 • GZMB • JAK3 • MYC • PD-L1 • TP63

Re-emergence and clinical management of monkeypox: insights into viral biology, therapeutics, and vaccination. (PubMed, Mol Biol Rep) - "Antiviral therapies such as tecovirimat (TPOXX), cidofovir, and brincidofovir are under consideration, with tecovirimat showing the most clinical promise...Currently approved vaccines include ACAM2000, LC16 KMB, and JYNNEOS (MVA-BN), with JYNNEOS preferred due to its safety profile, especially for immunocompromised individuals and pregnant women. Preventive strategies, public education, and international surveillance are essential to mitigate further outbreaks. Understanding the biology, clinical behavior, and control measures of Mpox is critical for informing future responses and improving global preparedness."

Journal • Review • Fatigue • Infectious Disease • Musculoskeletal Pain • Pain

ADENOVIRUS INFECTION IN ALLOGENEIC TRANSPLANT ADULT PATIENTS WITH POST-TRANSPLANT CYCLOPHOSPHAMIDE (SIE 2025) - "All pts received PTCy in association with sirolimus (31), MMF (28) and ATG (1) as GvHD prophylaxis...Overall, 21 pts received specific antiviral treatment, mainly based on intravenous immunoglobulin and cidofovir. Brincidofovir was administered as compassionate use in 6 pts...We reported AdV mainly in the context of haplo and MUD transplants, myeloablative conditioning regimen, severe aGvHD. In our analysis OS was positively affected by the introduction of AdV weekly monitoring which is warranted for early diagnosis and pre-emptive treatments."

Clinical • Post-transplantation • Acute Graft versus Host Disease • Bone Marrow Transplantation • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Graft versus Host Disease • Hematological Malignancies • Immunology • Infectious Disease • Transplantation

Brincidofovir in the Era of Mpox (ASTMH 2025) - "BCV moves intracellularly and is phosphorylated to cidofovir-diphosphate (CDV-PP), which then inhibits viral DNA polymerase activity. As reported from published cases, the use of BCV in 5 patients as a first-line treatment of clade II infections showed improved survival outcomes. Based on the mechanism of action of the drug, development of MPXV resistance to the viral DNA polymerase inhibitory activity of BCV is less likely to occur than with tecovirimat (TCV), which targets a viral surface protein. BCV has been demonstrated to be synergistic with TCV in vitro and in vivo in orthopoxviral infections."

Infectious Disease • Pediatrics

Evaluating the advancements and efficacies in pharmacological Mpox treatments: a comprehensive review. (PubMed, Front Pharmacol) - "Prominent reviewed stewards include tecovirimat, brincidofovir, and cidofovir: drugs first developed for smallpox but repositioned for Mpox under expanded access programs. The review endorses increased clinical trial capacities, amended regulatory approaches development of new classes of therapeutics as part of global Mpox response efforts. By combining pharmacological breakthroughs with public health readiness, global health communities can be better equipped to respond to Mpox and other possible orthopox outbreaks of the future."

Journal • Review • Infectious Disease