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Tecovirimat for Treatment of Monkeypox Virus

Phase 2
Completed
Conditions
Monkeypox
Interventions
Registration Number
NCT05559099
Lead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Brief Summary

The purpose of this study is to find out if tecovirimat is a safe and effective drug to treat monkeypox (mpox) in combination with standard of care (SOC). Participants will be randomly assigned to receive oral tecovirimat plus SOC or placebo plus SOC for 14 days.

Detailed Description

This is a randomized, placebo-controlled, double-blind study to test the antiviral drug tecovirimat for the treatment of adults and children with laboratory-confirmed monkeypox virus (MPXV) disease at participating sites in the Democratic Republic of Congo. Eligible and consented participants will be randomized 1:1 to receive either oral tecovirimat or placebo, each administered in the hospital with standard-of-care (SOC) treatment for 14 days. Participants will be followed for 28 days with an optional visit at Day 59 for long-term assessment.

If a participant reaches full body lesion resolution but subsequently develops at least one new lesion consistent with mpox after discharge but while still enrolled in the study, they will be eligible to make a sick visit and will be offered standard of care for mpox.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
597
Inclusion Criteria
  • Laboratory-confirmed monkeypox virus infection as determined by PCR obtained from blood, oropharynx, or skin lesion within 48 hours of screening

  • Monkeypox illness of any duration provided that the patient has at least one active, not yet scabbed, lesion

  • Weight ≥3 kg

  • Men and non-pregnant women of reproductive potential must agree to use effective means of contraception when engaging in sexual activities that can result in pregnancy, from the time of enrollment through the end of study participation. Acceptable methods of contraception include the following:

    • Hormonal contraception
    • Male or female condom
    • Diaphragm or cervical cap with a spermicide
    • Intrauterine device
  • Stated willingness to comply with all study procedures (including required inpatient stay) and availability for the duration of the study

  • Ability to provide informed consent personally or by a legally or culturally acceptable representative if the patient is unable to do so

Exclusion Criteria
  • Current or planned use of a meglitinide (repaglinide, nateglinide)
  • Planned use of midazolam while on study drug
  • Severe anemia, defined as hemoglobin <7 g/dL
  • Current or planned use of another investigational drug at any point during study participation
  • Patients who, in the judgement of the investigator, will be at significantly increased risk as a result of participation in the study
  • Participants who are unable to safely swallow oral medications, such as those who are at risk of aspiration

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TecovirimatTecovirimat Oral CapsuleTecovirimat capsules administered orally to participants for 14 days plus SOC.
PlaceboPlaceboMatching placebo capsules administered orally to participants for 14 days plus SOC.
Primary Outcome Measures
NameTimeMethod
Time to lesion resolutionup to day 28

Number of days to the first day on which all lesions on the total body are scabbed or desquamated or a new layer of epidermis has formed.

Secondary Outcome Measures
NameTimeMethod
Frequency of solicited clinical symptomsup to day 59

Clinical symptoms defined as: nausea, vomiting, abdominal pain, diarrhea, anorexia, cough, lymphadenopathy, dysphagia, sore throat, muscle aches, fatigue/lack of energy, fever, chills, night sweats, headache, ocular lesions, eye pain, change in vision, buccal ulcers, nasal congestion, cough, joint pain, pain with urination, painful skin lesions, pruritic skin lesions.

Number of participants with negative blood PCR resultsday 14

Proportion of participants with negative blood sample MPXV PCR results 14 days post-randomization

Number of participants with negative lesion swab PCR resultsday 14

Proportion of participants with negative lesion swab MPXV PCR results 14 days post-randomization

Mortality within the first 28 days post-randomizationup to day 28

Number of deaths post-randomization

Number of days to participant deathup to day 28

Number of days post-randomization

Incidence of adverse events requiring drug discontinuationup to day 14

Number of AEs

Time to lesion resolution for participants with symptom onset less than or equal to 7 days before randomizationup to day 28

Number of days to the first day on which all lesions on the total body are scabbed or desquamated or a new layer of epidermis has formed.

Time to lesion resolution for participants with symptom onset greater than 7 days before randomizationup to day 28

Number of days to the first day on which all lesions on the total body are scabbed or desquamated or a new layer of epidermis has formed.

Number of participants with negative oropharyngeal swab PCR resultsday 14

Proportion of participants with negative oropharyngeal swab MPXV PCR results 14 days post-randomization

Duration of solicited clinical symptomsup to day 59

Number of days

Incidence of other adverse eventsup to day 28

Number of AEs

Incidence of bacterial infectionsup to day 28

Number of clinically defined bacterial infections. Laboratory and radiographical confirmation when possible.

Incidence of serious adverse events requiring drug discontinuationup to day 14

Number of SAEs

Trial Locations

Locations (2)

L'Hôpital Général de Référence de Kole

🇨🇩

Kole, Congo, The Democratic Republic of the

L'Hôpital Général de Référence de Tunda

🇨🇩

Tunda, Congo, The Democratic Republic of the

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