Letermovir in lung transplant recipients with cytomegalovirus infection: A retrospective observational study
Letermovir is a new antiviral drug approved for the prophylaxis of CMV infection in allogeneic stem cell transplants. The aim of the study was to assess the therapeutic efficacy of letermovir in difficult to treat CMV infections in lung transplant recipients. All lung transplant recipients between M...
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| Veröffentlicht in: | American journal of transplantation 2021-10, Vol.21 (10), p.3449-3455 |
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| creator | Veit, Tobias Munker, Dieter Barton, Jürgen Milger, Katrin Kauke, Teresa Meiser, Bruno Michel, Sebastian Zoller, Michael Nitschko, Hans Keppler, Oliver T. Behr, Jürgen Kneidinger, Nikolaus |
| description | Letermovir is a new antiviral drug approved for the prophylaxis of CMV infection in allogeneic stem cell transplants. The aim of the study was to assess the therapeutic efficacy of letermovir in difficult to treat CMV infections in lung transplant recipients. All lung transplant recipients between March 2018 and August 2020, who have been treated with letermovir for ganciclovir‐resistant or refractory CMV infection were included in the study and analysed retrospectively. In total, 28 patients were identified. CMV disease was present in 15 patients (53.6%). In 23 patients (82.1%), rapid response was noticed, and CMV‐viral load could be significantly decreased (>1 log10) after a median of 17 [14–27] days and cleared subsequently in all of these patients. Five patients (17.9%) were classified as non‐responder. Thereof, development of a mutation of the CMV UL56 terminase (UL‐56‐Gen: C325Y) conferring letermovir resistance could be observed in three patients (60%). Common side effects were mild and mostly of gastrointestinal nature. Mild adjustments of the immunosuppressive drugs were mandatory upon treatment initiation with letermovir. In addition to other interventions, letermovir was effective in difficult to treat CMV infections in lung transplant recipients. However, in patients with treatment failure mutation conferring letermovir, resistance should be taken into account.
Letermovir is effective in difficult‐to‐treat cytomegalovirus infections in lung transplant recipients. |
| doi_str_mv | 10.1111/ajt.16718 |
| format | Article |
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Letermovir is effective in difficult‐to‐treat cytomegalovirus infections in lung transplant recipients.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/ajt.16718</identifier><identifier>PMID: 34118118</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Acetates ; antibiotic drug resistance ; antibiotic: antiviral ; Antibiotics ; Antiviral agents ; Antiviral Agents - therapeutic use ; Antiviral drugs ; clinical research/practice ; Cytomegalovirus ; Cytomegalovirus Infections - drug therapy ; Cytomegalovirus Infections - prevention & control ; Drug Resistance, Viral ; Ganciclovir ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunosuppressive agents ; infection and infectious agents ‐ viral: Cytomegalovirus (CMV) ; Infections ; infectious disease ; Lung ; lung disease: infectious ; Lung transplantation ; lung transplantation/pulmonology ; Lung transplants ; Mutation ; Observational studies ; Patients ; pharmacology ; Prophylaxis ; Quinazolines ; Retrospective Studies ; Stem cell transplantation ; Terminase ; Transplant Recipients</subject><ispartof>American journal of transplantation, 2021-10, Vol.21 (10), p.3449-3455</ispartof><rights>2021 The Authors. published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons</rights><rights>2021 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-66a37842f3e3200f05db6951c74f7e938435bb0f7dc13ee44a1aff2b108d6a6e3</citedby><cites>FETCH-LOGICAL-c3538-66a37842f3e3200f05db6951c74f7e938435bb0f7dc13ee44a1aff2b108d6a6e3</cites><orcidid>0000-0003-2914-8773 ; 0000-0001-7583-0453 ; 0000-0001-5471-578X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajt.16718$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajt.16718$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34118118$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Veit, Tobias</creatorcontrib><creatorcontrib>Munker, Dieter</creatorcontrib><creatorcontrib>Barton, Jürgen</creatorcontrib><creatorcontrib>Milger, Katrin</creatorcontrib><creatorcontrib>Kauke, Teresa</creatorcontrib><creatorcontrib>Meiser, Bruno</creatorcontrib><creatorcontrib>Michel, Sebastian</creatorcontrib><creatorcontrib>Zoller, Michael</creatorcontrib><creatorcontrib>Nitschko, Hans</creatorcontrib><creatorcontrib>Keppler, Oliver T.</creatorcontrib><creatorcontrib>Behr, Jürgen</creatorcontrib><creatorcontrib>Kneidinger, Nikolaus</creatorcontrib><title>Letermovir in lung transplant recipients with cytomegalovirus infection: A retrospective observational study</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>Letermovir is a new antiviral drug approved for the prophylaxis of CMV infection in allogeneic stem cell transplants. The aim of the study was to assess the therapeutic efficacy of letermovir in difficult to treat CMV infections in lung transplant recipients. All lung transplant recipients between March 2018 and August 2020, who have been treated with letermovir for ganciclovir‐resistant or refractory CMV infection were included in the study and analysed retrospectively. In total, 28 patients were identified. CMV disease was present in 15 patients (53.6%). In 23 patients (82.1%), rapid response was noticed, and CMV‐viral load could be significantly decreased (>1 log10) after a median of 17 [14–27] days and cleared subsequently in all of these patients. Five patients (17.9%) were classified as non‐responder. Thereof, development of a mutation of the CMV UL56 terminase (UL‐56‐Gen: C325Y) conferring letermovir resistance could be observed in three patients (60%). Common side effects were mild and mostly of gastrointestinal nature. Mild adjustments of the immunosuppressive drugs were mandatory upon treatment initiation with letermovir. In addition to other interventions, letermovir was effective in difficult to treat CMV infections in lung transplant recipients. However, in patients with treatment failure mutation conferring letermovir, resistance should be taken into account.
Letermovir is effective in difficult‐to‐treat cytomegalovirus infections in lung transplant recipients.</description><subject>Acetates</subject><subject>antibiotic drug resistance</subject><subject>antibiotic: antiviral</subject><subject>Antibiotics</subject><subject>Antiviral agents</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Antiviral drugs</subject><subject>clinical research/practice</subject><subject>Cytomegalovirus</subject><subject>Cytomegalovirus Infections - drug therapy</subject><subject>Cytomegalovirus Infections - prevention & control</subject><subject>Drug Resistance, Viral</subject><subject>Ganciclovir</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>infection and infectious agents ‐ viral: Cytomegalovirus (CMV)</subject><subject>Infections</subject><subject>infectious disease</subject><subject>Lung</subject><subject>lung disease: infectious</subject><subject>Lung transplantation</subject><subject>lung transplantation/pulmonology</subject><subject>Lung transplants</subject><subject>Mutation</subject><subject>Observational studies</subject><subject>Patients</subject><subject>pharmacology</subject><subject>Prophylaxis</subject><subject>Quinazolines</subject><subject>Retrospective Studies</subject><subject>Stem cell transplantation</subject><subject>Terminase</subject><subject>Transplant Recipients</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kUtLAzEUhYMotlYX_gEJuNFF22SSebkrxScFN3U9ZGZuasq8TDIt8-_NOLULwXAh4ea7h5wchK4pmVG35mJrZzQIaXSCxjQgZBpQzk6PZ-aP0IUxW0Jo6EXeORoxTmnkaoyKFVjQZb1TGqsKF221wVaLyjSFqCzWkKlGQWUN3iv7ibPO1iVsRNEPtMaNSMisqqsHvHCw1bVp-sYOcJ0a0DvRX4oCG9vm3SU6k6IwcHXYJ-jj6XG9fJmu3p9fl4vVNGM-i6ZBIFgYcU8yYB4hkvh5GsQ-zUIuQ4hZxJmfpkSGeUYZAOeCCim9lJIoD0QAbILuBt1G118tGJuUymRQOEtQtybxfE58Zz8mDr39g27rVrsX91REHBby2FH3A5U5g0aDTBqtSqG7hJKkjyBxESQ_ETj25qDYpiXkR_L3zx0wH4C9KqD7XylZvK0HyW_irZHL</recordid><startdate>202110</startdate><enddate>202110</enddate><creator>Veit, Tobias</creator><creator>Munker, Dieter</creator><creator>Barton, Jürgen</creator><creator>Milger, Katrin</creator><creator>Kauke, Teresa</creator><creator>Meiser, Bruno</creator><creator>Michel, Sebastian</creator><creator>Zoller, Michael</creator><creator>Nitschko, Hans</creator><creator>Keppler, Oliver T.</creator><creator>Behr, Jürgen</creator><creator>Kneidinger, Nikolaus</creator><general>Elsevier Limited</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2914-8773</orcidid><orcidid>https://orcid.org/0000-0001-7583-0453</orcidid><orcidid>https://orcid.org/0000-0001-5471-578X</orcidid></search><sort><creationdate>202110</creationdate><title>Letermovir in lung transplant recipients with cytomegalovirus infection: A retrospective observational study</title><author>Veit, Tobias ; Munker, Dieter ; Barton, Jürgen ; Milger, Katrin ; Kauke, Teresa ; Meiser, Bruno ; Michel, Sebastian ; Zoller, Michael ; Nitschko, Hans ; Keppler, Oliver T. ; Behr, Jürgen ; Kneidinger, Nikolaus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-66a37842f3e3200f05db6951c74f7e938435bb0f7dc13ee44a1aff2b108d6a6e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acetates</topic><topic>antibiotic drug resistance</topic><topic>antibiotic: antiviral</topic><topic>Antibiotics</topic><topic>Antiviral agents</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Antiviral drugs</topic><topic>clinical research/practice</topic><topic>Cytomegalovirus</topic><topic>Cytomegalovirus Infections - drug therapy</topic><topic>Cytomegalovirus Infections - prevention & control</topic><topic>Drug Resistance, Viral</topic><topic>Ganciclovir</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Immunosuppressive agents</topic><topic>infection and infectious agents ‐ viral: Cytomegalovirus (CMV)</topic><topic>Infections</topic><topic>infectious disease</topic><topic>Lung</topic><topic>lung disease: infectious</topic><topic>Lung transplantation</topic><topic>lung transplantation/pulmonology</topic><topic>Lung transplants</topic><topic>Mutation</topic><topic>Observational studies</topic><topic>Patients</topic><topic>pharmacology</topic><topic>Prophylaxis</topic><topic>Quinazolines</topic><topic>Retrospective Studies</topic><topic>Stem cell transplantation</topic><topic>Terminase</topic><topic>Transplant Recipients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Veit, Tobias</creatorcontrib><creatorcontrib>Munker, Dieter</creatorcontrib><creatorcontrib>Barton, Jürgen</creatorcontrib><creatorcontrib>Milger, Katrin</creatorcontrib><creatorcontrib>Kauke, Teresa</creatorcontrib><creatorcontrib>Meiser, Bruno</creatorcontrib><creatorcontrib>Michel, Sebastian</creatorcontrib><creatorcontrib>Zoller, Michael</creatorcontrib><creatorcontrib>Nitschko, Hans</creatorcontrib><creatorcontrib>Keppler, Oliver T.</creatorcontrib><creatorcontrib>Behr, Jürgen</creatorcontrib><creatorcontrib>Kneidinger, Nikolaus</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Veit, Tobias</au><au>Munker, Dieter</au><au>Barton, Jürgen</au><au>Milger, Katrin</au><au>Kauke, Teresa</au><au>Meiser, Bruno</au><au>Michel, Sebastian</au><au>Zoller, Michael</au><au>Nitschko, Hans</au><au>Keppler, Oliver T.</au><au>Behr, Jürgen</au><au>Kneidinger, Nikolaus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Letermovir in lung transplant recipients with cytomegalovirus infection: A retrospective observational study</atitle><jtitle>American journal of transplantation</jtitle><addtitle>Am J Transplant</addtitle><date>2021-10</date><risdate>2021</risdate><volume>21</volume><issue>10</issue><spage>3449</spage><epage>3455</epage><pages>3449-3455</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><abstract>Letermovir is a new antiviral drug approved for the prophylaxis of CMV infection in allogeneic stem cell transplants. The aim of the study was to assess the therapeutic efficacy of letermovir in difficult to treat CMV infections in lung transplant recipients. All lung transplant recipients between March 2018 and August 2020, who have been treated with letermovir for ganciclovir‐resistant or refractory CMV infection were included in the study and analysed retrospectively. In total, 28 patients were identified. CMV disease was present in 15 patients (53.6%). In 23 patients (82.1%), rapid response was noticed, and CMV‐viral load could be significantly decreased (>1 log10) after a median of 17 [14–27] days and cleared subsequently in all of these patients. Five patients (17.9%) were classified as non‐responder. Thereof, development of a mutation of the CMV UL56 terminase (UL‐56‐Gen: C325Y) conferring letermovir resistance could be observed in three patients (60%). Common side effects were mild and mostly of gastrointestinal nature. Mild adjustments of the immunosuppressive drugs were mandatory upon treatment initiation with letermovir. In addition to other interventions, letermovir was effective in difficult to treat CMV infections in lung transplant recipients. However, in patients with treatment failure mutation conferring letermovir, resistance should be taken into account.
Letermovir is effective in difficult‐to‐treat cytomegalovirus infections in lung transplant recipients.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>34118118</pmid><doi>10.1111/ajt.16718</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-2914-8773</orcidid><orcidid>https://orcid.org/0000-0001-7583-0453</orcidid><orcidid>https://orcid.org/0000-0001-5471-578X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acetates antibiotic drug resistance antibiotic: antiviral Antibiotics Antiviral agents Antiviral Agents - therapeutic use Antiviral drugs clinical research/practice Cytomegalovirus Cytomegalovirus Infections - drug therapy Cytomegalovirus Infections - prevention & control Drug Resistance, Viral Ganciclovir Hematopoietic Stem Cell Transplantation Humans Immunosuppressive agents infection and infectious agents ‐ viral: Cytomegalovirus (CMV) Infections infectious disease Lung lung disease: infectious Lung transplantation lung transplantation/pulmonology Lung transplants Mutation Observational studies Patients pharmacology Prophylaxis Quinazolines Retrospective Studies Stem cell transplantation Terminase Transplant Recipients |
| title | Letermovir in lung transplant recipients with cytomegalovirus infection: A retrospective observational study |
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