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Cytomegalovirus Therapy: Role of Letermovir in Prophylaxis and Treatment in Transplant Recipients.

Publication ,  Journal Article
Saullo, JL; Miller, RA
Published in: Annu Rev Med
January 27, 2023

Cytomegalovirus (CMV) is a common viral pathogen in the transplant population and is associated with significant morbidity and mortality. CMV prevention is paramount; however, selecting the best preventive strategy depends on many factors including donor-recipient CMV serostatus, transplant-specific risks, antiviral toxicities and cost. Novel CMV therapeutics such as letermovir (LTV) are desperately needed to optimize CMV management. Uniquely among CMV antiviral therapies, LTV inhibits the viral terminase complex in the CMV DNA synthesis pathway and disrupts viral genome packaging. Further, it lacks side effects frequently associated with other CMV antiviral therapies and evades common mechanisms of resistance. LTV is approved by the US Food and Drug Administration for CMV prevention in adult CMV-seropositive hematopoietic cell transplant recipients but is increasingly applied off-label for prophylaxis and treatment. This review summarizes important concepts of CMV management in transplantation, with a specific focus on LTV pharmacology and clinical experience to date alongside future prospects for its application.

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Published In

Annu Rev Med

DOI

EISSN

1545-326X

Publication Date

January 27, 2023

Volume

74

Start / End Page

89 / 105

Location

United States

Related Subject Headings

  • Transplant Recipients
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • General & Internal Medicine
  • Cytomegalovirus Infections
  • Cytomegalovirus
  • Antiviral Agents
  • Adult
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Saullo, J. L., & Miller, R. A. (2023). Cytomegalovirus Therapy: Role of Letermovir in Prophylaxis and Treatment in Transplant Recipients. Annu Rev Med, 74, 89–105. https://doi.org/10.1146/annurev-med-042921-124739
Saullo, Jennifer L., and Rachel A. Miller. “Cytomegalovirus Therapy: Role of Letermovir in Prophylaxis and Treatment in Transplant Recipients.Annu Rev Med 74 (January 27, 2023): 89–105. https://doi.org/10.1146/annurev-med-042921-124739.
Saullo, Jennifer L., and Rachel A. Miller. “Cytomegalovirus Therapy: Role of Letermovir in Prophylaxis and Treatment in Transplant Recipients.Annu Rev Med, vol. 74, Jan. 2023, pp. 89–105. Pubmed, doi:10.1146/annurev-med-042921-124739.

Published In

Annu Rev Med

DOI

EISSN

1545-326X

Publication Date

January 27, 2023

Volume

74

Start / End Page

89 / 105

Location

United States

Related Subject Headings

  • Transplant Recipients
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • General & Internal Medicine
  • Cytomegalovirus Infections
  • Cytomegalovirus
  • Antiviral Agents
  • Adult
  • 3202 Clinical sciences
  • 1103 Clinical Sciences