5PSQ-034 Tecovirimat against monkeypox: safety, efficacy and patient feedback

<h3>Background and Importance</h3> In July 2022 and August 2024, WHO declared monkeypox (MPOX) outbreaks as public health emergencies. Currently, in September 2025, cases remain uncontrolled in central-eastern Africa, and therapeutic options are almost non-existent. Tecovirimat, active against <i>Orthopoxvirus,</i> inhibits p37 protein, preventing viral envelope formation. In our country, it is only available via special import authorisation. <h3>Aim and Objectives</h3> To evaluate tecovirimat’s safety and efficacy through clinical data and patient feedback from MPOX cases treated at our centre. <h3>Material and Methods</h3> We analysed clinical and demographic data from patients treated between June 2022 and September 2025 at a tertiary hospital. Satisfaction was assessed using TSQM 1.4 (Treatment Satisfaction Questionnaire for Medication). All participants gave informed consent; protocol was approved by the ethics committee. <h3>Results</h3> Fourteen patients were treated (13 men, 1 trans woman; median age 36). Seven (50%) were HIV-positive, five of whom had good virological and immunological control while two had viral loads of 1,300,000 and 49,800 c/mL and CD4 + 158 and 166 per µL, respectively. Only one had previously received the MPOX vaccine. Tecovirimat was prescribed in severe cases: Among HIV+ patients, 3 had ocular lesions, 2 had poor immune control, 1 presented a polymicrobial septic shock. Among immunocompetent patients, 5 had ocular lesions (57.1% overall), 1 had brain involvement. In addition, one patient in each group didn’t respond to symptomatic treatment. Most (57.1%) received 600 mg/12h for 14 days. Two had shorter courses (5 and 7 days), the first due to early recovery (vaccinated) and the other due to an adverse event. Two received 28-days treatments (ocular lesions and dosing error) and the last two received five 14-day cycles (both with ocular lesions). TSQM scores (n=13) were effectiveness 81.7%, convenience 93.8%, global satisfaction 75.3%. Six patients (42.9%) reported mild adverse effects (stomach ache, nausea, diarrhoea); one (7.1%) developed probable toxic hepatitis (Naranjo score 5/13), requiring treatment discontinuation. <h3>Conclusion and Relevance</h3> Tecovirimat was generally safe and well tolerated, though close monitoring is advised. Vaccination may help prevent complications. Further research is needed to confirm efficacy and explore new treatments. <h3>Conflict of Interest</h3> No conflict of interest