Tecovirimat is a drug on its way to FDA approval, but as F. Perry Wilson, MD, describes in this 150-Second Analysis, if anyone ever has to prescribe this drug we are in deep, deep trouble.
When I pitched reviewing this study to my producer, he said, "You want to talk about a drug no one is ever going to use?" Yes. Yes I do.
The drug is tecovirimat and the disease it treats is smallpox.
Smallpox, through the power of vaccination, was eradicated in 1980. This is Rahima Banu. She was one of the last recorded cases. She survived, by the way.
But how do you test a drug for a disease that no longer exists?
Well, smallpox may not exist. But monkeypox and rabbitpox exist and have been validated as animal models for human smallpox.
Would tecovirimat save animals infected with these viruses? The results were fairly compelling. The mortality rate for monkeys infected with monkeypox was 95% in the absence of the drug. With treatment (initiated at 4 days after the monkeys developed skin lesions), the mortality rate dropped to zero. Similar numbers were seen in the rabbitpox model.