A large-scale clinical trial published in the New England Journal of Medicine has found that tecovirimat, an FDA-approved antiviral medication originally developed for smallpox, failed to demonstrate therapeutic advantage in treating mpox infections in ambulatory adults. The randomized, placebo-controlled STOMP trial enrolled 412 participants with clade II mpox and measured clinical outcomes over a 29-day period.
Results revealed comparable efficacy between treatment groups, with 79% of patients receiving tecovirimat achieving clinical resolution by day 29, compared with 81% in the placebo group. The study found no statistically significant differences between the two cohorts in secondary outcomes, including pain reduction and lesion healing rates. These findings challenge earlier assumptions about the drug's effectiveness against mpox and suggest that current symptomatic management approaches may be sufficient for outpatient treatment in this patient population.
The STOMP trial represents one of the largest controlled studies of tecovirimat in mpox patients to date. The results may inform treatment guidelines and clinical decision-making as health authorities continue monitoring mpox transmission patterns and evaluating therapeutic interventions for this emerging infectious disease.