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la <span class="elsevierStyleItalic">Vaccinia</span> progresiva o la <span class="elsevierStyleItalic">Vaccinia</span> generalizada grave<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a>&#46; La pauta de administraci&#243;n es 6&#46;000 U&#47;kg tan pronto como los primeros s&#237;ntomas de enfermedad aparezcan&#44; pudi&#233;ndose repetir la dosis seg&#250;n la gravedad de la cl&#237;nica y la respuesta a la dosis inicial &#40;incluso puede considerarse una dosis de 9&#46;000 U&#47;kg si el paciente no ha respondido a la primera dosis&#41;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a>&#46; Pese a que existen datos a favor de su uso contra la viruela s&#237;mica&#44; como la gran similitud gen&#243;mica entre los <span class="elsevierStyleItalic">Orthopoxvirus</span><a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a>&#44; hasta el momento no se han realizado ensayos en humanos sobre su uso con esta indicaci&#243;n&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; 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Carta al Director
Inmunoglobulina anti-Vaccinia y profilaxis postexposición mediante vacuna basada en Vaccinia para el control del brote de viruela símica (Monkeypox)
Anti-Vaccinia Immunoglobulin and Post-exposure Prophylaxis with Vaccinia-based Vaccine for Management of the Monkeypox Outbreak
F.J. Rodríguez-Cuadradoa,
Corresponding author
, E.L. Pinto-Pulidob, M. Fernández-Parradoc
a Servicio de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
b Servicio de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, España
c Servicio de Dermatología, Hospital Universitario de Navarra, Pamplona, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Hace un tiempo publicamos en esta revista una breve revisi&#243;n de los potenciales tratamientos disponibles o en proceso de estudio que podr&#237;an resultar de utilidad en el control del entonces incipiente brote de viruela s&#237;mica &#40;monkeypox&#41;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#46; En ella destac&#225;bamos el papel de tecovirimat como &#250;nico f&#225;rmaco antiviral aprobado por la Agencia Europea del Medicamento &#40;EMA&#41;&#44; debido a su buen perfil de seguridad y demostrada eficacia en cuanto a reducci&#243;n de la mortalidad en modelos animales<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Como respuesta a dicha publicaci&#243;n&#44; los doctores Sookaromdee y Wiwanitkit dirigieron una carta titulada &#171;Treatments for Monkeypox&#187;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>&#44; en la que comparten su opini&#243;n respecto al uso del tecovirimat y mencionan el posible uso de inmunoglobulina intravenosa como otro potencial tratamiento eficaz en la viruela s&#237;mica&#44; ya declarada &#171;emergencia sanitaria internacional&#187; por la Organizaci&#243;n Mundial de la Salud &#40;OMS&#41;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Una de las afirmaciones que realizan Sookaromdee y Wiwanitkit es que&#44; si bien el tecovirimat ha mostrado eficacia&#44; no resulta un f&#225;rmaco ampliamente utilizado en los pa&#237;ses en los que el <span class="elsevierStyleItalic">Monkeypox virus</span> ha sido tradicionalmente end&#233;mico<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>&#46; Un posible motivo de la escasa utilizaci&#243;n del tecovirimat en dichos pa&#237;ses es que sus recursos y estructuras sanitarias no son comparables a aquellas de los pa&#237;ses europeos<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>&#46; Adem&#225;s&#44; hay que a&#241;adir que la aprobaci&#243;n por la EMA<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> no es aplicable en el continente africano&#44; y de momento es la &#250;nica agencia sanitaria que ha aprobado el f&#225;rmaco con la indicaci&#243;n de viruela s&#237;mica&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El segundo aspecto que quer&#237;amos comentar es el posible uso de inmunoglobulina contra <span class="elsevierStyleItalic">Vaccina virus</span> de administraci&#243;n intravenosa&#44; sugerido por Sookaromdee y Wiwanitkit<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>&#46; Esta inmunoglobulina se encuentra indicada exclusivamente para el tratamiento de ciertas complicaciones causadas por la administraci&#243;n de la vacuna derivada de <span class="elsevierStyleItalic">Vaccinia virus</span>&#44; tales como el <span class="elsevierStyleItalic">eczema vaccinatum</span>&#44; la <span class="elsevierStyleItalic">Vaccinia</span> progresiva o la <span class="elsevierStyleItalic">Vaccinia</span> generalizada grave<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a>&#46; La pauta de administraci&#243;n es 6&#46;000 U&#47;kg tan pronto como los primeros s&#237;ntomas de enfermedad aparezcan&#44; pudi&#233;ndose repetir la dosis seg&#250;n la gravedad de la cl&#237;nica y la respuesta a la dosis inicial &#40;incluso puede considerarse una dosis de 9&#46;000 U&#47;kg si el paciente no ha respondido a la primera dosis&#41;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a>&#46; Pese a que existen datos a favor de su uso contra la viruela s&#237;mica&#44; como la gran similitud gen&#243;mica entre los <span class="elsevierStyleItalic">Orthopoxvirus</span><a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a>&#44; hasta el momento no se han realizado ensayos en humanos sobre su uso con esta indicaci&#243;n&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; es preciso destacar el empleo de la vacuna derivada de <span class="elsevierStyleItalic">Vaccinia virus</span> como profilaxis postexposici&#243;n&#46; La OMS recomienda actualmente la administraci&#243;n de una vacuna de segunda o tercera generaci&#243;n para los contactos de los casos en los primeros cuatro d&#237;as desde la exposici&#243;n<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a>&#46; Se estima que dicha vacuna podr&#237;a proporcionar inmunidad cruzada contra el <span class="elsevierStyleItalic">Monkeypox virus</span> con una eficacia de aproximadamente un 80-85&#37;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a>&#44; previsiblemente consecuencia de la anteriormente mencionada similitud gen&#243;mica entre <span class="elsevierStyleItalic">Orthopoxvirus</span><a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a>&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financiaci&#243;n</span><p id="par0030" class="elsevierStylePara elsevierViewall">Ninguna&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conficto de intereses</span><p id="par0035" class="elsevierStylePara elsevierViewall">Ninguno&#46;</p></span></span>"
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Article information
ISSN: 00017310
Original language: Spanish
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Idiomas
Actas Dermo-Sifiliográficas
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?