Premium
A Multicenter Study of Valganciclovir Prophylaxis up to Day 120 in CMV‐Seropositive Lung Transplant Recipients
Author(s) -
Monforte V.,
Lopez C.,
Santos F.,
Zurbano F.,
De La Torre M.,
Sole A.,
Gavalda J.,
Ussetti P.,
Lama R.,
Cifrian J.,
Borro J. M.,
Pastor A.,
Len O.,
Bravo C.,
Roman A.
Publication year - 2009
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2009.02574.x
Subject(s) - valganciclovir , medicine , ganciclovir , gastroenterology , lung transplantation , incidence (geometry) , basiliximab , chemoprophylaxis , cytomegalovirus , transplantation , adverse effect , leukopenia , immunology , human cytomegalovirus , kidney transplantation , chemotherapy , viral disease , virus , herpesviridae , physics , optics
Seventy‐six cytomegalovirus (CMV)‐seropositive lung transplant recipients receiving valganciclovir (900 mg/day) for CMV prophylaxis were compared with a group of 87 patients receiving oral ganciclovir (3000 mg/day). Prophylaxis was administered to day 120 post‐transplantation and follow‐up was 1 year. In addition, a study was conducted on risk factors for CMV infection/disease. CMV disease incidence was 7.9% and 16.1% for valganciclovir and oral ganciclovir, respectively (p = 0.11). Patients receiving valganciclovir had fewer viral syndromes (2.6% vs. 11.5%, p < 0.05), a similar rate of tissue‐invasive disease (5.2% vs. 4.6%, p = ns), longer time‐to‐onset of CMV infection/disease (197.5 vs. 155.2 days, p < 0.05), and a lower probability of infection/disease while on prophylaxis (1.3% vs. 12.6%, p < 0.01). Nonetheless, leukopenia incidence was higher with valganciclovir (15.8% vs. 2.3%, p < 0.01), as was the need for treatment withdrawal due to adverse effects (11.8% vs. 1.1%, p < 0.01). CMV infection was similar in both groups (32.9% vs. 34.5%). Induction therapy with basiliximab and glucocorticosteroid treatment were independent risk factors for developing CMV infection/disease. In conclusion, valganciclovir prophylaxis results in a low incidence of CMV disease in lung transplant recipients and appears more effective than oral ganciclovir. Despite the comparatively higher incidence of adverse events with valganciclovir, the drug can be considered safe for prophylaxis.