Cidofovir tied to quicker lesion clearance in patients with monkeypox

Treatment with topical cidofovir leads to faster clearance of skin lesions in patients with monkeypox but mild systemic involvement, according to a study. Time to resolution reduction can shorten isolation time and enhance the cosmetic impact in areas such as the face.

In this prospective study, the authors obtained data on the clinical and virologic course of patients with monkeypox, all of whom were offered symptomatic treatment. Treatment with topical cidofovir on a compassionate use basis was also recommended to these patients. Of these, 12 received topical cidofovir 1%, while the rest received only symptomatic treatment (nontreated group). Finally, the authors scheduled prospective visits to collect clinical and virologic data.

Patients in the cidofovir group demonstrated quicker lesions clearance than did those in the nontreated group (hazard ratio, 4.572; p=0.0039). The median time to resolution was 12 and 18 days, respectively. Polymerase chain reaction-positive skin lesions on day 14 were fewer in the cidofovir group compared with the nontreated group (10 percent vs 62.5 percent; p=0.019).

In addition, local adverse effects occurred frequently (50 percent), particularly in the anogenital region, but no systemic adverse effects were observed.

The study was limited by its design and the absence of a placebo-controlled group.

“Human monkeypox has become increasingly frequent worldwide since the outbreak was first reported in May 2022,” the authors said.