- |||||||||| Review, Journal: New Treatment Options for Refractory/Resistant CMV Infection. (Pubmed Central) - Oct 30, 2023
Recent introduction of new CMV agents including maribavir and letermovir as well as the use of adoptive T cell therapy may improve the outcome of these difficult-to-treat infections in SOT recipients. In this expert review, we focus on new treatment options for resistant/refractory CMV infection and disease in SOT recipients, with an emphasis on maribavir, letermovir, and adoptive T cell therapy.
- |||||||||| Prevymis (letermovir) / Merck (MSD), Valcyte (valganciclovir) / Roche, Mitsubishi Tanabe, Livtencity (maribavir) / Takeda, GSK
Journal: What's New: Updates on Cytomegalovirus in Solid Organ Transplantation. (Pubmed Central) - Oct 30, 2023 Maribavir preemptive therapy failed to demonstrate noninferiority when compared with valganciclovir in hematopoietic stem cell transplant recipients but looked promising for safety...Standardized definitions for the design of CMV clinical trials have been developed. In this review, we highlight recent updates in the field from data published since 2018.
- |||||||||| Prevymis (letermovir) / Merck (MSD)
Trial completion date, Trial primary completion date: Letermovir in ART-treated HIV-infected Persons (clinicaltrials.gov) - Oct 19, 2023 P=N/A, N=60, Recruiting, No abstract available Trial completion date: Dec 2023 --> Dec 2025 | Trial primary completion date: Apr 2023 --> Apr 2025
- |||||||||| Prevymis (letermovir) / Merck (MSD)
Retrospective data, Journal: Letermovir for Cytomegalovirus prophylaxis in pediatric hematopoietic stem cell transplantation. (Pubmed Central) - Sep 26, 2023 Letermovir is an effective antiviral agent for CMV prevention and has demonstrated enhanced safety, which may allow for extended durations of primary prophylaxis among transplant recipients along with other improved clinical outcomes by mitigating the indirect effects of CMV. In this retrospective study, the use of LTV prophylaxis in pediatric stem cell patients was associated with reduced clinically significant CMV DNAemia through D+180.
- |||||||||| Prevymis (letermovir) / Merck (MSD), Livtencity (maribavir) / Takeda, GSK
Clinical, Review, Journal: Management of Cytomegalovirus infection in allogeneic hematopoietic stem cell transplants. (Pubmed Central) - Jul 18, 2023 Maribavir is a new drug that showed promising results in the treatment of refractory/resistant CMV disease. Other alternative treatments like cellular adoptive immunotherapy and artesunate or leflunomide might play an adjunctive role in the treatment of challenging cases, however further investigation is warranted.
- |||||||||| Journal: Factors Associated With Genotypic Resistance and Outcome Among Solid Organ Transplant Recipients With Refractory Cytomegalovirus Infection. (Pubmed Central) - Jul 7, 2023
Age (OR = 0.94 per year, IC95 [0.089-0.99]), a history of valganciclovir (VGCV) underdosing or of low plasma concentration (OR= 5.6, IC95 [1.69-20.7]), being on VGCV at infection onset (OR = 3.11, IC95 [1.18-5.32]) and the recipients' CMV negative serostatus (OR = 3.40, IC95 [0.97-12.8]) were independently associated with CMV genotypic resistance...CMV genotypic resistance to antivirals was independently associated with a younger age, exposure to low levels of GCV, the recipients' negative serostatus, and presenting the infection on VGCV prophylaxis. This data is of importance, given that we also found a poorer outcome in the patients of the resistant group.
- |||||||||| Journal: Prevalence of cytomegalovirus antiviral drug resistance in transplant recipients. (Pubmed Central) - Jun 5, 2023
While a high prevalence of CMV resistance mutations was identified, this must be taken in the context of healthcare providers submitting samples from patients with suspected resistant CMV strains. For these patients, rapid monitoring for resistance allows treatment modifications based on objective results rather than empiric drug selection, which is particularly relevant given the presence of mutations conferring resistance to more than one drug.
- |||||||||| Prevymis (letermovir) / Merck (MSD), Cytovene (ganciclovir) / Roche
Review, Journal: Targeting the Host Mitochondria as a Novel Human Cytomegalovirus Antiviral Strategy. (Pubmed Central) - May 31, 2023 Targeting host mitochondrial function is a promising alternative or complimentary antiviral approach as (1) drugs targeting host mitochondrial function interact with host targets, minimizing viral resistance, and (2) host mitochondrial metabolism plays key roles in HCMV replication. This review describes how HCMV alters mitochondrial function and highlights pharmacological targets that can be exploited for novel antiviral development.
- |||||||||| Prevymis (letermovir) / Merck (MSD)
Journal: CD4+ T cells are the major predictor of HCMV control in allogeneic stem cell transplant recipients on letermovir prophylaxis. (Pubmed Central) - May 30, 2023 High numbers of HCMV-specific CD4+ T cells and low numbers of Tregs seem to be pivotal to suppress post-alloSCT HCMV reactivation during letermovir prophylaxis. Administration of more advanced immunoassays that include Treg signature cytokines might contribute to the identification of patients at high-risk for long-term and symptomatic HCMV reactivation who might benefit from prolonged administration of letermovir.
|