The following is a summary of “Human monkeypox outbreak: Epidemiological data and therapeutic potential of topical cidofovir in a prospective cohort study,” published in the MAY 2023 issue of Dermatology by Sobral-Costas, et al.

Monkeypox is a disease caused by Orthopoxvirus that has been increasingly reported worldwide since May 2022. Cidofovir is effective against other Orthopoxvirus diseases, such as vaccinia. For a study, researchers sought to evaluate the efficacy and safety of topical cidofovir in treating monkeypox skin lesions as an alternative to systemic administration.

A prospective study was conducted to gather information on monkeypox patients’ clinical and virologic progression. A symptomatic approach was taken with all patients. On a compassionate-use basis, they were also given access to topical cidofovir therapy. Only symptomatic care was given to the remaining patients; only 12 individuals got treatment with topical cidofovir 1%. Clinical and virological data were to be gathered through prospective visits.

The cidofovir-treated group had quicker lesion resolution than the non-treated group (hazard ratio, 4.572; P = .0039). The median time to resolution was 12 (11.5-15) days in the cidofovir group and 18 (16-21) days in the non-treated group. On day 14, polymerase chain reaction-positive skin lesions were detected in 10% of the cidofovir sample and 62.5% of the non-treated group (P = .019). Local adverse effects were frequent (50%), especially in the anogenital region, but no systemic adverse effects were reported.

Topical cidofovir may be an effective treatment for monkeypox skin lesions, particularly in cases with mild systemic involvement. Using topical cidofovir could shorten isolation time, improve cosmetic outcomes, and avoid the potential adverse effects of systemic administration. Further studies were needed to determine the optimal dosage and duration of treatment.