Abstract:
The monkeypox disease (MPX) outbreak of 2022 has been reported in more than one
hundred countries and is becoming a global concern. Unfortunately, only a few treatments, such as
tecovirimat (TCV), are available against MPX. Brincidofovir (BCV) is a United States Food and Drug
Administration (USFDA)-approved antiviral against smallpox. This article reviews the potential of
BCV for treating MPX and other Orthopoxvirus (OPXVs) diseases. The literature for this review
was collected from PubMed, authentic websites (USFDA, Chimerix), and freely available patent
databases (USPTO, Espacenet, and Patentscope). BCV (a lipophilic derivative of cidofovir) has been
discovered and developed by Chimerix Incorporation, USA. Besides smallpox, BCV has also been
tested clinically for various viral infections (adenovirus, cytomegalovirus, ebola virus, herpes simplex
virus, and double-stranded DNA virus). Many health agencies and reports have recommended using
BCV for MPX. However, no health agency has yet approved BCV for MPX. Accordingly, the off-label
use of BCV is anticipated for MPX and various viral diseases. The patent literature revealed some
important antiviral compositions of BCV. The authors believe there is a huge opportunity to create
novel, inventive, and patentable BCV-based antiviral therapies (new combinations with existing
antivirals) for OPXVs illnesses (MPX, smallpox, cowpox, camelpox, and vaccinia). It is also advised
to conduct drug interaction (food, drug, and disease interaction) and drug resistance investigations
on BCV while developing its combinations with other medications. The BCV-based drug repurposing
options are also open for further exploration. BCV offers a promising opportunity for biosecurity
against OPXV-based bioterrorism attacks and to control the MPX outbreak of 2022.
