Effect of mTOR inhibitors during CMV disease in kidney transplant recipients: Results of a pilot retrospective study.
Adult
Aged
Antiviral Agents
/ therapeutic use
Cytomegalovirus
Cytomegalovirus Infections
/ drug therapy
Female
Humans
Immunophenotyping
Kidney Transplantation
/ adverse effects
Male
Middle Aged
Mycophenolic Acid
/ therapeutic use
Protein Kinase Inhibitors
/ therapeutic use
Retrospective Studies
TOR Serine-Threonine Kinases
/ antagonists & inhibitors
CMV persistence
CMV recurrence
cytomegalovirus
kidney transplantation
mTOR inhibitors
Journal
Microbiology and immunology
ISSN: 1348-0421
Titre abrégé: Microbiol Immunol
Pays: Australia
ID NLM: 7703966
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
11
02
2020
revised:
28
03
2020
accepted:
31
03
2020
pubmed:
7
4
2020
medline:
20
1
2021
entrez:
7
4
2020
Statut:
ppublish
Résumé
mTOR inhibitors exert a preventive effect on cytomegalovirus (CMV) disease in CMV seropositive (R+) kidney transplant recipients, but their impact during the curative treatment of CMV disease in high-risk kidney transplant recipients has not been investigated. We aimed to evaluate the efficacy and tolerance of mTOR inhibitors compared with mycophenolic acid in 63 consecutive kidney transplant recipients (80% of D+R-) suffering from CMV disease with a persistent or a recurrent CMV DNAemia. In this monocentric retrospective study, 16 had their treatment converted to mTOR inhibitors and 47 did not. The Kaplan-Meier curves did not show any significant differences in CMV DNAemia eradication (77% vs. 88% respectively; hazard ratio (HR), 1.648 [95% confidence interval (CI), 0.913-2.973]; log-rank test, P = .132), DNAemia recurrence (36% vs. 47%; HR, 1.517 [95% CI, 0.574-4.007]; log-rank test, P = .448) and CMV clinical recurrence (17% vs. 27%; HR, 1.375 [95% CI, 0.340-5.552]; log-rank test, P = .677) between patients who received mTOR inhibitors and those who did not. These results were confirmed in uni- and multivariate time-dependent Cox regressions. In summary, conversion from mycophenolic acid to mTOR inhibitors seems inadequate for improving CMV clearance or in better preventing CMV recurrences during severe or persistent CMV disease.
Identifiants
pubmed: 32249964
doi: 10.1111/1348-0421.12794
doi:
Substances chimiques
Antiviral Agents
0
Protein Kinase Inhibitors
0
MTOR protein, human
EC 2.7.1.1
TOR Serine-Threonine Kinases
EC 2.7.11.1
Mycophenolic Acid
HU9DX48N0T
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
520-531Informations de copyright
© 2020 The Societies and John Wiley & Sons Australia, Ltd.
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