TPOXX (tecovirimat) / SIGA Technologies - LARVOL DELTA

Balancing Rejection and Infection Risk: A Case of Disseminated Mpox in an HIV-Positive Kidney Transplant Recipient (KIDNEY WEEK 2026) - "Maintenance immunosuppression included tacrolimus, mycophenolate mofetil, and prednisone...The patient was treated with tecovirimat and brincidofovir for 2 weeks with resolution of the lesions...Figure 1. Disseminated facial mpox lesions"

Clinical • Human Immunodeficiency Virus • Infectious Disease • Transplant Rejection • Transplantation

Differential pathogenesis and antiviral treatment outcomes of MPXV clade Ib and clade IIb in a BALB/c mouse model. (PubMed, Emerg Microbes Infect) - "Antiviral evaluation showed that tecovirimat and cidofovir were active against both clades, although a higher dose of cidofovir was required to achieve protection in the clade Ib infection model. Together, these findings establish a susceptible BALB/c mouse model for MPXV clade Ib and provide experimental evidence for clade-dependent differences in MPXV pathogenicity and antiviral treatment outcomes."

Journal • Preclinical • Infectious Disease

National Reach and State-Level Variation of Participant Enrollment into ACTG A5418/STOMP, the US Trial of tecovirimat for mpox Treatment (IDWeek 2026) - No abstract available

Infectious Disease

Insights into the Life Cycle and Therapeutic Agents for Monkeypox Virus Infection. (PubMed, Chem Rev) - "Despite decades of research, only tecovirimat has been approved by the European Medicines Agency (EMA) for the treatment of MPXV infection...A variety of antiviral agents against MPXV and other OPXVs are discussed according to their distinct mechanisms of action: 1) blocking viral entry and fusion, 2) inhibiting DNA replication and processing, 3) disrupting transcription and mRNA processing, 4) preventing virion assembly, maturation and release, 5) modulating immune responses, and 6) mechanism unknown. Overall, this article provides a systematic review of current research progress on potential therapeutic targets and agent for MPXV, aiming to offer innovative insights and strategies for the development of effective therapeutic agents against mpox."

Journal • Review • Infectious Disease

Mpox in Europe, 2022-2026: A Scoping Review of Viral Clades, Host Determinants of Severity and Antiviral Therapy. (PubMed, Viruses) - "Tecovirimat failed to improve outcomes in four randomised trials, F13L-associated resistance was reported in advanced HIV, and its European mpox use was subsequently restricted. The evidence base is strongest for mild Clade IIb infection in immunocompetent adults and weakest for the groups most likely to need treatment. Preparedness should prioritise harmonised genomic surveillance, severity-stratified cohort data and adaptive therapeutic trials enrolling immunocompromised, paediatric, pregnant and older patients."

Journal • Infectious Disease • Pediatrics • CD4

Mpox in advanced AIDS with concurrent opportunistic infections: periprocedural management challenges. (PubMed, Infect Prev Pract) - "Tecovirimat was obtained under the Centers for Disease Control and Prevention (CDC) expanded-access protocol and administered for 14 days with epithelialization of skin lesions, suggesting resolution of mpox except for persistent mpox polymerase chain reaction positivity of one epithelialized lesion.Our team deferred inpatient lymph node biopsy because neither the CDC nor World Health Organization guidelines provide specific periprocedural isolation workflows (e.g. procedure room selection, anaesthesia considerations, staff personal protective equipment beyond standard recommendations, and postprocedure decontamination) for mpox patients, and we found no state, national, or international guidelines addressing periprocedural isolation precautions for mpox. This case highlights the management complexity of mpox in advanced AIDS with multiple concurrent opportunistic infections. It also underscores operational gaps for time-sensitive procedures in patients requiring mpox..."

Journal • Anesthesia • Cough • Epstein-Barr Virus Infections • Human Immunodeficiency Virus • Infectious Disease • Kaposi Sarcoma • Oncology • Pneumonia • Respiratory Diseases • Sarcoma • Solid Tumor

Integrated molecular, epidemiological, and bioinformatics perspectives on the Mpox virus: Implications for surveillance and Global Health preparedness. (PubMed, J Microbiol Methods) - "This review summarizes the clinical findings of PALM007 and STOMP, noting that neither trial achieved its main efficacy endpoint making routine tecovirimat use less compelling-while leaving open whether it helps particular high-risk groups. A further point is that immunity from the MVA-BN vaccine wanes with time, leading to the growing adoption of booster vaccinations. In conclusion, the review calls for a One Health approach pairing genomic tracking with ecological intelligence and including wastewater surveillance to fill existing gaps in knowledge and enhance the global handling of new orthopoxvirus threats."

Journal • Review

Treatment of mpox with tecovirimat under expanded access use in the Central African Republic. (PubMed, Int J Infect Dis) - "While no clear treatment benefit was demonstrated, the programme improved understanding of disease and strengthened clinical and research capacity."

Journal • Musculoskeletal Pain • Pain

Total body photography for standardised documentation of mpox skin lesions in remote study sites in the Democratic Republic of the Congo. (PubMed, BMJ Glob Health) - "We designed and successfully implemented photography protocols for the PALM007 (Pamoja Tulinde Maisha - Together Save Lives in Swahili) randomised clinical trial evaluating tecovirimat for the treatment of mpox in the Democratic Republic of the Congo (DRC)...Our developed procedures enabled acquisition of 61 926 standardised, clinical-quality photographs of 597 patients with mpox. These considerations may guide future studies collecting standardised photographs in a low-resource setting."

Clinical • Journal

Tecovirimat treatment of clade II mpox: a virological analysis of a randomised, double-blind, phase 3 trial. (PubMed, Lancet Microbe) - P3 | "Although treatment-emergent resistance to tecovirimat was rare overall, it was observed more often in participants living with advanced HIV and profoundly impaired cellular immunity, leading to persistently higher viral loads and delayed clinical recovery. Tecovirimat therapy of mpox infection did not reduce the frequency of MPXV isolation from skin swabs. Novel therapeutic options are needed to address mpox infection."

Journal • P3 data • Allergy • Human Immunodeficiency Virus • Immunology • Infectious Disease • Pediatrics • CD4

Clinical Course and Virologic Dynamics of Mpox During Tecovirimat Treatment: Prospective Multicenter Case Series in Japan. (PubMed, J Infect Chemother) - "This prospective multicenter case series describes the clinical course of mpox and temporal dynamics of skin PCR negativity in patients receiving tecovirimat in real-world practice."

Journal • Human Immunodeficiency Virus • Infectious Disease • CD4

Effect of tecovirimat on MPXV DNA clearance in participants randomized in the ANRS 0576s UNITY trial (AIDS 2026) - "Tecovirimat did not reduce time to undetectability of MPXV DNA among patients with Mpox disease, but it did lower viral loads in oral samples at D8 and D15."

Clinical • Late-breaking abstract • Human Immunodeficiency Virus • Infectious Disease • CD4

Challenges and lessons from Mpox response in Puerto Rico: provider perspectives on diagnosis, management, and preparedness (AIDS 2026) - " Providers reported receiving extensive guidance from the Department of Health (DoH) on managing suspected and confirmed Mpox cases, including symptom recognition, lesion identification, screening, sample collection, biosafety, isolation, TPOXX administration, and vaccination... These findings indicate that, despite comprehensive guidance, healthcare providers faced substantial diagnostic, logistical, and psychosocial challenges during the Mpox outbreak. Strengthening early, practical training, inter-clinic coordination, and operational capacity, alongside addressing stigma and vaccine hesitancy, is critical for improving preparedness and response to future emerging infectious diseases."

Infectious Disease

The evolution of tecovirimat resistance in an immunocompromised individual with severe mpox infection. (PubMed, Diagn Microbiol Infect Dis) - "Susceptibility to cidofovir and brincidofovir was preserved, and initiation of cidofovir was associated with clinical improvement and cessation of new lesions. This case demonstrates rapid intra-host evolution of multi-lineage tecovirimat resistance in severe mpox, highlighting the need for resistance surveillance and alternative or combination antiviral strategies in immunocompromised patients."

Journal • Human Immunodeficiency Virus • Infectious Disease • CD4

Seminal fluid enhances monkeypox virus infection via amyloidogenic fibrils. (PubMed, Emerg Microbes Infect) - "SEVI increased virion attachment and uptake, and fibril-targeting molecular tweezer (CLR01) disrupted seminal amyloids and abrogated enhancement. Notably, tecovirimat and brincidofovir retained activity under SEVI-enhanced conditions. These findings identify seminal amyloids as host factors that amplify MPXV infectivity and broaden cell tropism, suggesting that semen actively promotes sexual transmission of mpox."

Journal • Infectious Disease

The Evolving Landscape of Monkeypox: From Endemic Pathogen to Global Threat. (PubMed, Vector Borne Zoonotic Dis) - "The continued reemergence of mpox underscores the necessity for an integrated "One Health" approach to surveillance and pandemic preparedness. Future research must prioritize environmental wildlife monitoring, genomic surveillance of emerging clades, and the development of multi-epitope vaccines to effectively mitigate both zoonotic spillover and human transmission."

Journal • Review • Infectious Disease

Research Progress and Challenges of Anti-monkeypox Virus Drugs Targeting F13 Protein. (PubMed, J Med Chem) - "Nevertheless, clinical trials prove tecovirimat has weak efficacy and poor resistance profile...Current improvements include domain optimization to enhance bioavailability, simplified pharmacophores to boost potency, skeletal editing for better solubility, novel scaffolds for virion assembly inhibition, and dual antiviral-anti-inflammatory agents. Crucially, future paradigms must break away from standalone F13 monotherapy and transition toward combination regimens─such as pairing F13 blockers with host-targeting entry/uncoating inhibitors─or developing multitarget inhibitors that interrupt the viral life cycle prior to IMV maturation by targeting DNA polymerase or transcription machinery."

Journal • Review • Infectious Disease

Prolonged mpox infection and fatal outcome in an HIV patient treated with tecovirimat. (PubMed, Int J Infect Dis) - "We found progressive within-host viral diversification across lesions from different anatomical sites, including the emergence of a mutation previously associated with tecovirimat resistance. These findings highlight the need to investigate alternative therapeutic strategies for MPXV in severely immunocompromised patients."

Journal • Human Immunodeficiency Virus • Infectious Disease

Severe mpox in an immunocompromised, non-traveller South African male. (PubMed, S Afr J Infect Dis) - "Management included supportive care and tecovirimat under Section 21 authorisation (a regulatory mechanism in South Africa permitting access to an unregistered medicine) with good clinical response. This case highlights the changing epidemiology of mpox, the risk of severe disease in immunocompromised patients, household and non-sexual transmission. We also emphasise the importance of early diagnosis, infection control and antiviral therapy when indicated."

Journal • Human Immunodeficiency Virus • Infectious Disease

An integrated review of monkeypox: from pathogen and epidemiology to diagnostics, control, and challenges. (PubMed, Emerg Microbes Infect) - "Although smallpox-related drugs (such as tecovirimat, cidofovir, and brincidofovir) show potential, their clinical efficacy needs to be verified. Prevention and control rely on a stronger monitoring system, timely risk warnings, and public health education. This article reviews the recent progress in MPXV detection, vaccine development, and antibody-based therapy, providing new insights for mpox prevention and control."

Journal • Review • Infectious Disease

Exploring drug repurposing for monkeypox virus: A structural and computational approach. (PubMed, J Taibah Univ Med Sci) - "Due to the structural and evolutionary similarities among these orthopoxviruses, the Food and Drug Administration (FDA)-approved smallpox drug tecovirimat was selected as a reference drug...These findings provide promising leads for the development of new therapeutic applications, thereby enhancing both the public health response and commercial value of repurposed treatments. MD simulations also supported the stability and feasibility of these promising drug-protein complexes."

Journal • Infectious Disease

Computational analysis and validation of UGT1A1/4 missense variants impacting tecovirimat metabolism in monkeypox patients. (PubMed, Front Syst Biol) - "Specifically, the UGT1A1 SNPs G308R, P356T and G374S, while in UGT1A4 the SNPs G309R, P357T and G375S, were predicted to be the most harmful missense SNPs. These mutations could affect drug-enzyme binding, potentially altering tecovirimat's therapeutic efficacy."

Journal • Infectious Disease • UGT1A1

Monkeypox: A Viral Zoonotic Disease of Rising Global Concern. (PubMed, Infect Dis Immun) - "Although limited approved antiviral treatments are available, such as tecovirimat, which the European Medicines Agency approved in January 2022 for the treatment of mpox, their widespread availability and effectiveness in the current outbreak remain to be investigated...This review summarizes the current literature on mpox virology, epidemiology, pathogenesis, clinical manifestations, diagnostics, treatment, prevention, and public health control measures. Ongoing investigation and research are needed to better understand mpox's evolving epidemiology, pathogenicity, transmissibility, and ecology to guide strategies for containing the outbreak and preventing future global emergence."

Journal • Review • Infectious Disease

UNITY: Assessment of the Efficacy and Safety of Tecovirimat in Patients With Monkeypox Virus Disease (clinicaltrials.gov) - P3 | N=480 | Active, not recruiting | Sponsor: ANRS, Emerging Infectious Diseases | Recruiting ➔ Active, not recruiting | Trial primary completion date: Sep 2025 ➔ Sep 2026

Enrollment closed • Trial primary completion date • Infectious Disease

Mpox in Solid Organ Transplant Recipients: Lessons from a Single-Center Case Series in South Florida. (PubMed, Transpl Infect Dis) - No abstract available

Journal • Solid Organ Transplantation • Transplantation