New Drug Candidate Identified Against Mpox

Nitroxoline is the name of the new drug candidate that could potentially be used to treat mpox. It was identified by scientists at Goethe University and the University of Kent as part of a multi-site study. The results of their research will now allow clinical trials to begin soon.

The current mpox outbreak is the first of this size to occur outside of Africa and also the first mpox outbreak caused by human-to-human transmission. People with immunodeficiencies are particularly at risk from the disease. Although antiviral agents have already been shown to inhibit the replication of the mpox virus in experimental models, the efficacy of these substances has not yet been confirmed in humans and some may have significant side effects. In addition, there are insufficient stocks to treat all mpox patients. Moreover, resistance formation against tecovirimat, the most promising mpox drug candidate to date, has already been reported.

In the present study, the international team led by Professor Jindrich Cinatl (of Goethe University Frankfurt and the Dr. Petra Joh-Research Institute) and Professor Martin Michaelis (School of Biosciences, University of Kent) has identified nitroxoline, a well-tolerated antibiotic, as a potential treatment alternative for the mpox virus based on experiments using cell culture and skin explant models.

Nitroxoline is also effective against a tecovirimat-resistant strain of the mpox virus, as well as other bacterial and viral pathogens that are frequently co-transmitted with mpox viruses, meaning it simultaneously suppresses multiple pathogens that are often involved in severe courses of mpox. Since nitroxoline is a well-tolerated antibiotic that has long been used to treat humans, it can be tested directly against mpox in clinical trials.

"The emergence of resistant virus strains is a cause of great concern,” says Professor Jindrich Cinatl of Goethe University and the Dr. Petra Joh-Research Institute. "It is very reassuring that nitroxoline is effective against a tecovirimat-resistant virus."

Professor Martin Michaelis of the University of Kent adds: "The more different drugs become available to treat viral diseases, the better. We hope that nitroxoline will turn out to be an effective treatment for mpox patients."

Reference: Bojkova D, Zöller N, Tietgen M, et al. Repurposing of the antibiotic nitroxoline for the treatment of mpox. J Med Virol. 2023;95(3):e28652. doi: 10.1002/jmv.28652

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