ArticlePediatric transplantation2014
New algorithm for valganciclovir dosing in pediatric solid organ transplant recipients.
Article in Pediatric transplantation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 50 citations in OpenAlex.
- Pilot Study of Model-Based Dosage Individualization of Ganciclovir in Neonates and Young Infants with Congenital Cytomegalovirus Infection.Antimicrobial agents and chemotherapy · 2018Trial
- Ganciclovir Dosing in Premature Infants Receiving Treatment for Congenital Cytomegalovirus Infection: Results of a Prospective Pharmacokinetic Study.The Journal of infectious diseases · 2026Article
- Article
- Debates in Management and Treatment of CMV in Pediatric Solid Organ Transplant Recipients: A Case-Based Discussion.Pediatric transplantation · 2025Review
- Limited Sampling Strategies to Predict Ganciclovir Exposure after Valganciclovir Administration and to Reduce Monitoring Constraints in Renal Transplant Children.Antimicrobial agents and chemotherapy · 2023Article
- Standard ganciclovir dosing results in slow decline of cytomegalovirus viral loads.The Journal of antimicrobial chemotherapy · 2022Article
- Therapeutic Drug Monitoring of Ganciclovir: Where Are We?Therapeutic drug monitoring · 2022Review
- The need for area under the curve measurements in the field of ganciclovir therapeutic drug monitoring in children: a case report.BMC infectious diseases · 2021Article
- Thoroughly Validated Bayesian Estimator and Limited Sampling Strategy for Dose Individualization of Ganciclovir and Valganciclovir in Pediatric Transplant Recipients.Clinical pharmacokinetics · 2021Article
- Valganciclovir prophylaxis for cytomegalovirus infection in pediatric kidney transplant recipients: a single-center experience.Clinical and experimental nephrology · 2021Article
- Population Pharmacokinetics of Intravenous Ganciclovir and Oral Valganciclovir in a Pediatric Population To Optimize Dosing Regimens.Antimicrobial agents and chemotherapy · 2021Article
- Article
- Population pharmacokinetics of ganciclovir after valganciclovir in renal transplant children.Antimicrobial agents and chemotherapy · 2019Article
- Pediatric Dosing of Ganciclovir and Valganciclovir: How Model-Based Simulations Can Prevent Underexposure and Potential Treatment Failure.CPT: pharmacometrics & systems pharmacology · 2019Article
- Therapeutic Drug Monitoring of Ganciclovir Treatment for Cytomegalovirus Infections Among Immunocompromised Children.Journal of the Pediatric Infectious Diseases Society · 2016Article
- Cytomegalovirus Infection in Pediatric Solid Organ Transplant Recipients: a Focus on Prevention.Current infectious disease reports · 2016Article
- Use of Modeling and Simulation in the Design and Conduct of Pediatric Clinical Trials and the Optimization of Individualized Dosing Regimens.CPT: pharmacometrics & systems pharmacology · 2015Article
- A Matched Case-Control Study to Evaluate Predicted Drug Exposures and Neutropenia during Valganciclovir Prophylaxis in Pediatric Solid Organ Transplant Recipients.Transplant infectious disease : an official journal of the Transplantation SocietyArticle
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
Abstract
CMV infections are common after SOT. v-GCV is increasingly used in children. The aim of this study was to evaluate presently used dosing algorithms. Data from 104 pediatric SOT recipients (kidney, liver, and heart) aged 0.3-16.9 yr and receiving v-GCV once a day were used for model development and validation with the Pmetrics package for R. Monte Carlo simulations were performed to compare the probability of a GCV AUC 40-60 mg*h/L with the different algorithms across a range of ages, weights, and GFRs. GCV pharmacokinetics was well described by the non-parametric model. Clearance was dependent on GFR and Cockcroft-Gault estimates improved the model fit over Schwartz. Simulations showed that our new algorithm, where v-GCV dose is: Weight [kg]*(0.07*GFR [mL/min]+k), where k = 5 for GFR ≤ 30 mL/min, k = 10 for GFR > 30 mL/min and weight > 30 kg and k = 15 for GFR > 30 mL/min and weight ≤ 30 kg, outperformed the other algorithms. Thirty-three percent of all patients achieve an exposure above and 21% within the therapeutic window. We propose a simple algorithm for initial v-GCV dosing that standardizes plasma drug exposure better than current algorithms. Subsequent TDM is strongly suggested to achieve individual drug levels within the therapeutic window.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.