Letermovir as Salvage Therapy for Cytomegalovirus Infection in Transplant Recipients.
Acetates
/ therapeutic use
Adult
Aged
Antiviral Agents
/ therapeutic use
Cytomegalovirus
/ drug effects
Cytomegalovirus Infections
/ drug therapy
Female
Follow-Up Studies
Hematopoietic Stem Cell Transplantation
/ adverse effects
Humans
Male
Middle Aged
Organ Transplantation
/ adverse effects
Quinazolines
/ therapeutic use
Retrospective Studies
Salvage Therapy
/ methods
Transplant Recipients
Viral Load
/ drug effects
Journal
Transplantation
ISSN: 1534-6080
Titre abrégé: Transplantation
Pays: United States
ID NLM: 0132144
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
entrez:
31
1
2020
pubmed:
31
1
2020
medline:
30
9
2020
Statut:
ppublish
Résumé
Letermovir, a new viral terminase complex inhibitor, has been approved for the prevention of cytomegalovirus (CMV) infection in hematopoietic stem cell transplant patients. However, data on the efficacy and safety of letermovir for the treatment of CMV infection in transplant recipients remain scarce. We performed a single-center retrospective study of stem cell and organ transplant recipients who received letermovir for the treatment of CMV infection from November 2017 to October 2018. Six patients were included, and 5 were evaluable. All received letermovir in the context of a refractory or resistant CMV infection including asymptomatic CMV viremia (n = 3), CMV syndrome (n = 1), and CMV pneumonitis and colitis (n = 1). The 3 asymptomatic patients experienced a decrease of the viral load (VL) to <200 IU/mL after letermovir therapy. One patient displayed a partial VL response (2-log of VL reduction) but a good clinical response, and one who received a suboptimal dose of letermovir experienced an increase of viremia. There were no treatment-related adverse effects. We demonstrate mixed efficacy in patients with refractory CMV infection suggesting that letermovir may be a useful therapeutic adjunct, potentially in combination with other antivirals.
Sections du résumé
BACKGROUND
Letermovir, a new viral terminase complex inhibitor, has been approved for the prevention of cytomegalovirus (CMV) infection in hematopoietic stem cell transplant patients. However, data on the efficacy and safety of letermovir for the treatment of CMV infection in transplant recipients remain scarce.
METHODS
We performed a single-center retrospective study of stem cell and organ transplant recipients who received letermovir for the treatment of CMV infection from November 2017 to October 2018.
RESULTS
Six patients were included, and 5 were evaluable. All received letermovir in the context of a refractory or resistant CMV infection including asymptomatic CMV viremia (n = 3), CMV syndrome (n = 1), and CMV pneumonitis and colitis (n = 1). The 3 asymptomatic patients experienced a decrease of the viral load (VL) to <200 IU/mL after letermovir therapy. One patient displayed a partial VL response (2-log of VL reduction) but a good clinical response, and one who received a suboptimal dose of letermovir experienced an increase of viremia. There were no treatment-related adverse effects.
CONCLUSIONS
We demonstrate mixed efficacy in patients with refractory CMV infection suggesting that letermovir may be a useful therapeutic adjunct, potentially in combination with other antivirals.
Identifiants
pubmed: 32000236
doi: 10.1097/TP.0000000000002785
pii: 00007890-202002000-00030
doi:
Substances chimiques
Acetates
0
Antiviral Agents
0
Quinazolines
0
letermovir
1H09Y5WO1F
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
404-409Références
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