Summary

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• Tecovirimat (TPOXX) is indicated for the treatment of human smallpox disease in adults and pediatric patients weighing at least 3 kg and has also been explored for use against monkeypox.
• Five studies were reviewed which primarily compared tecovirimat with two other antivirals: brincidofovir and cidofovir.
• Tecovirimat emerged as the most prominently used and beneficial antiviral in the treatment of monkeypox, showing a high report of symptom resolution without major safety concerns according to these studies.
• Brincidofovir showed potential safety issues related to liver injury not associated with tecovirimat usage; it was less favorable due to adverse events leading to discontinuation. Cidofovir appears less commonly used possibly due to availability or side effect profile considerations.
• One study highlighted limited observational studies reporting uneventful treatment with tecovirimat in children and pregnant individuals, though conclusive data on safety or efficacy are inadequately represented within these subgroups.
• The studies concluded that while tecovirimat holds promise particularly when compared to other antiviral options, gaps exist necessitating cautious interpretation of findings until more robust clinical trials can conclusively establish its safety and effectiveness across all possible subgroups including children, pregnant women, those with severe disease or immunosuppression.