Markets may be in free fall, but a few biotech companies had an exceptionally good day. Siga shares are up more than 40%; Emergent Biosolutions gained nearly 12% and Tonix Pharmaceuticals 15%. Outside the United States, Danish company Bavarian Nordic jumped 19%.
The reason? They make treatments for monkeypox.
A few cases of monkeypox have been recorded in Europe and North America, far from West and Central Africa where outbreaks usually occur. With covid still very much around and fresh memories of early 2020, the alert rose rapidly, increasing manufacturers’ shares of the drugs that would be needed to treat an outbreak of monkeypox.
What treatments are available for monkeypox?
There is no specific treatment for monkeypox. Existing treatments for the disease were initially approved as a defense against biological attack. The smallpox virus belongs to the orthopoxvirus family and shares important similarities with an old enemy of mankind: smallpox. Fortunately, compared to smallpox, monkeypox is less lethal – between 1% and 3% of patients die from it, compared to 30% mortality for smallpox.
The two viruses are similar enough that treatments developed for smallpox can also be used with monkeypox. And while there are no specific treatments for monkeypox – an existing disease that has affected thousands of people in several African countries since the 1970s – there are plenty available for smallpox.
The latest drugs approved by the Food and Drugs Administration (FDA) to treat smallpox are Tpoxx (generic name: tecovirimat), manufactured by Siga Technologies, and Tembexa (generic name: brincidofovir), which Emergent Biosolutions has just acquired from its developer Chimerix for $325. million. Both drugs are antivirals, taken by mouth or by injection. There is also a smallpox vaccine, made by Bavarian Nordic, and another by Tonix Pharmaceutical in the pipeline.
Why do we use smallpox treatments for monkeypox?
That’s a lot of options for treating a disease that was declared eradicated in 1980. But these vaccines and antivirals weren’t developed to cure existing diseases. They exist in case someone decides to bring back smallpox (also known as the pox virus) as a weapon.
“Although naturally occurring smallpox no longer exists, concerns about potential uses of the smallpox virus as a bioweapon have made the development of smallpox drugs an important part of the countermeasures response. U.S. medical products,” the FDA explained in its 2021 approval memo for Tembexa. The same goes for Canada and European countries, which stockpile treatments as a counterattack.
While bioterrorism is a serious threat, there is something ironic about the fact that European countries have to order smallpox treatments from the United States to treat monkeypox, a disease that rich countries had no thought since the first official case in 1970. But like the spread of covid, recent outbreaks of monkeypox show that viruses don’t respect borders. “To say ‘nobody is OK if we are not all OK’ is not just a slogan, but an inherent truth in the principle of global health,” says Nadia Sam-Agudu, professor of pediatrics at the Institute of Virology. Humanity from the University of Maryland.
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