{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:51:04Z","timestamp":1791489064501,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Reviews in Medical Virology"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Tecovirimat has been widely used for the treatment of mpox despite limited evidence supporting its efficacy. We conducted a systematic review and meta\u2010analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of tecovirimat for this purpose. PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to June 5, 2026 for RCTs comparing tecovirimat with placebo or standard care in patients with laboratory\u2010confirmed mpox. Primary outcomes were time to clinical resolution of skin lesions, clinical resolution by day 28\u201329, and 28\u2010day all\u2010cause mortality. Hazard ratios (HRs) and risk ratios (RRs) were pooled using random\u2010effects models with restricted maximum likelihood estimation and Hartung\u2013Knapp\u2013Sidik\u2013Jonkman adjustment. Risk of bias was assessed using RoB 2 and certainty of evidence using GRADE. Two low\u2010risk\u2010of\u2010bias RCTs involving 941 participants were included. Tecovirimat did not shorten the time to clinical resolution of skin lesions compared with placebo (HR 1.10, 95% CI 0.52\u20132.31, GRADE: moderate) or increase the lesion resolution by day 28\u201329 (RR 1.00, 95% CI 0.92\u20131.08, GRADE: high). No statistical heterogeneity was observed (I\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a00% for both outcomes). Mortality at day 28 was rare in both trials, precluding meta\u2010analysis. Virological clearance, pain\u2010related outcomes, and serious adverse events were also comparable between treatment groups. In conclusion, current randomized evidence does not support routine tecovirimat use to accelerate clinical recovery or improve mortality rates in patients with mpox, while further evidence is needed to determine whether selected high\u2010risk populations may benefit from antiviral therapy.\n                  <\/jats:p>","DOI":"10.1002\/rmv.70215","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:07:06Z","timestamp":1791486426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Tecovirimat for the Treatment of Mpox Virus Infection in Humans: Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9002-9214","authenticated-orcid":false,"given":"Davi M.","family":"Grecco","sequence":"first","affiliation":[{"name":"Department of Medicine Federal University of Santa Maria (UFSM)  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3379-0199","authenticated-orcid":false,"given":"Luciano","family":"Araldi","sequence":"additional","affiliation":[{"name":"Department of Medicine Federal University of Santa Maria (UFSM)  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2884-0845","authenticated-orcid":false,"given":"Giordano C.","family":"Soldera","sequence":"additional","affiliation":[{"name":"Department of Medicine Federal University of Santa Maria (UFSM)  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0771-6687","authenticated-orcid":false,"given":"Jo\u00e3o A.\u00a0B.","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Department of Medicine Federal University of Santa Maria (UFSM)  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8986-1211","authenticated-orcid":false,"given":"Jo\u00e3o V.","family":"Brisolara","sequence":"additional","affiliation":[{"name":"Department of Medicine Federal University of Santa Maria (UFSM)  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7132-9561","authenticated-orcid":false,"given":"Giovanna A.","family":"Artero","sequence":"additional","affiliation":[{"name":"Department of Medicine Universidade Nove de Julho (UNINOVE)  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9490-2606","authenticated-orcid":false,"given":"Luiza F.","family":"Streher","sequence":"additional","affiliation":[{"name":"Universidade Franciscana  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4222-115X","authenticated-orcid":false,"given":"Maria E.\u00a0F.","family":"Turatti","sequence":"additional","affiliation":[{"name":"Department of Medicine Universidade do Planalto Catarinense (UNIPLAC)  Lages Santa Catarina Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7630-8413","authenticated-orcid":false,"given":"Harapan","family":"Harapan","sequence":"additional","affiliation":[{"name":"Department of Microbiology School of Medicine Universitas Syiah Kuala  Banda Aceh Indonesia"},{"name":"Tropical Disease Center School of Medicine Universitas Syiah Kuala  Banda Aceh Indonesia"},{"name":"Medical Research Unit School of Medicine Universitas Syiah Kuala  Banda Aceh Indonesia"},{"name":"Tsunami &amp; Disaster Mitigation Research Center (TDMRC) Universitas Syiah Kuala  Banda Aceh 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\u201d accessed July 13 2026 https:\/\/www.gradepro.org\/."},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1411"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2022.12.027"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pbio.3002249"},{"key":"e_1_2_14_26_1","unstructured":"ANRS Emerging Infectious Diseases \u201cLarge International Trial UNITY Reports No Clinical Benefit From Tecovirimat for Mpox Resolution \u201d accessed July 13 2026 https:\/\/anrs.fr\/en\/all\u2010news\/large\u2010international\u2010trial\u2010unity\u2010reports\u2010no\u2010clinical\u2010benefit\u2010from\u2010tecovirimat\u2010for\u2010mpox\u2010resolution\/."},{"key":"e_1_2_14_27_1","unstructured":"University of Oxford \u201cPLATINUM Trial Results \u201d accessed July 13 2026 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