ArticleInternational journal of hematology2022
Differences in kinetics of tacrolimus concentration after letermovir discontinuation by type of concomitant azole antifungal.
Article in International journal of hematology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 12 citations in OpenAlex.
- Voriconazole as a Secondary Prophylaxis for Invasive Fungal Infections in Allogeneic Hematopoietic Stem Cell Transplantation: Real-world Evidence From a Major Transplantation Center in Taiwan.Open forum infectious diseases · 2026Article
- Concomitant letermovir affects the optimal concentration-to-dose ratio of tacrolimus after switching from intravenous to oral tacrolimus administration in hematopoietic cell transplantation patients receiving fluconazole prophylaxis.International journal of hematology · 2025Article
- Time in therapeutic range of tacrolimus in allogeneic hematopoietic stem cell transplant recipients is associated with acute graft-versus-host disease prophylaxis.Scientific reports · 2025Article
- Drug-Drug Interaction Management with the Novel Anti-Cytomegalovirus Agents Letermovir and Maribavir: Guidance for Clinicians.Clinical pharmacokinetics · 2024Review
- Interactions with the CYP3A inhibitor voriconazole differ between extended-LCP- and immediate-release tacrolimus formulations.International journal of hematology · 2022Article
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9 authors at 2 institutions in 2 countries.
Funding
Abstract
Letermovir is commonly used for CMV prophylaxis after allogeneic hematopoietic cell transplantation (HCT). Pharmacokinetic studies have shown an increase in tacrolimus exposure among healthy volunteers who took letermovir. However, studies in HCT recipients are needed because these patients are typically using concomitant antifungals with different degrees of CYP3A4 inhibition that may further interact with tacrolimus pharmacokinetics. In this study, we retrospectively evaluated the kinetics of tacrolimus concentration after letermovir discontinuation by type of concomitant azole antifungal in 57 HCT recipients. The median fold change in tacrolimus concentration-to-dose (C/D) ratio after discontinuing letermovir was 0.64 (range 0.43-0.99) with fluconazole and 1.10 (range 0.59-1.73) with voriconazole (p < 0.001). The tacrolimus C/D ratio decreased ≥ 30% after discontinuing letermovir (p < 0.001) in 66% of patients on fluconazole and 9% on voriconazole. Among patients whose tacrolimus C/D ratio decreased ≥ 30%, three (9%) patients in the fluconazole group and one (4%) in the voriconazole group experienced worsening of GVHD. Careful monitoring of tacrolimus concentration is important after letermovir discontinuation to avoid worsening of GVHD due to decreased tacrolimus concentration.
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