Trial reportThe Journal of infectious diseases2024
Drug Resistance Assessed in a Phase 3 Clinical Trial of Maribavir Therapy for Refractory or Resistant Cytomegalovirus Infection in Transplant Recipients.
Trial report in The Journal of infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02931539 (A Phase 3, Multicenter, Randomized, Open-label, Active-controlled Study to Assess the Efficacy and Safety of Maribavir Treatment Compared to Investigator-assigned Treatment in Transplant Recipients With Cytomegalovirus), which is not on this map. Cited by 40 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
A Phase 3, Multicenter, Randomized, Open-label, Active-controlled Study to Assess the Efficacy and Safety of Maribavir Treatment Compared to Investigator-assigned Treatment in Transplant Recipients With Cytomegalovirus (CMV) Infections That Are Refractory or Resistant to Treatment With Ganciclovir, Valganciclovir, Foscarnet, or Cidofovir
Who cites it
40 citing papers in PubMed, 71 citations in OpenAlex.
- Efficacy and safety of maribavir in Japanese patients with post-transplant cytomegalovirus infections: a phase III study.International journal of hematology · 2026Trial
- CMV-specific T-cell receptor-engineered T-cell therapy as first-line treatment for CMV reactivation after haploidentical hematopoietic stem cell transplantation: a phase 2 trial.Frontiers in immunology · 2026Trial
- Comparative Emergence of Maribavir and Ganciclovir Resistance in a Randomized Phase 3 Clinical Trial for Treatment of Cytomegalovirus Infection.The Journal of infectious diseases · 2025Trial
- Population pharmacokinetics and exposure-response relationships of maribavir in transplant recipients with cytomegalovirus infection.Journal of pharmacokinetics and pharmacodynamics · 2024Trial
- Human Cytomegalovirus Genetic Diversity, Clinical Relevance, and Emerging Insights.Reviews in medical virology · 2026Review
- Maribavir in lung transplant recipients with cytomegalovirus infection: real-life experience.Infection · 2026Article
- Article
- Maribavir for cytomegalovirus retinitis: A case series and review of the literature.AJO international · 2026Article
- Adoptive γδ T cell therapy controls cytomegalovirus infection in preclinical transplantation models.Nature communications · 2026Article
- A new locus of foscarnet resistance in the cytomegalovirus UL54 DNA polymerase gene among uncharacterized mutations in recent clinical trials.Antiviral research · 2026Article
- "Innovative diagnostics and treatments of infections in transplantation," report from the 2025Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Beyond Thresholds: CMV Replication Kinetics as Early Predictors of Clinical Risk in Transplant Recipients.Infection and drug resistance · 2026Review
- Current and Future Strategies for the Prevention and Treatment of Cytomegalovirus Infections in Transplantation.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Review
- Optimizing maribavir management: The role of health system specialty pharmacies in access, monitoring, and waste reduction.Journal of managed care & specialty pharmacy · 2025Article
- Generation of a panel of mutants that are resistant to standard of care therapies in a clinically relevant strain of human cytomegalovirus for drug resistance profiling.Antiviral research · 2025Article
- Debates in Management and Treatment of CMV in Pediatric Solid Organ Transplant Recipients: A Case-Based Discussion.Pediatric transplantation · 2025Review
- Real-world safety of maribavir: a retrospective study based on signal detection in the FDA adverse event reporting system.International journal of clinical pharmacy · 2025Article
- Inhibition of MAPK signaling suppresses cytomegalovirus reactivation in CD34Antiviral research · 2025Article
- Article
- Cytomegalovirus Retinitis in a Hematopoietic Stem Cell Transplant Recipient During Maribavir Pre-emptive Therapy.Infection & chemotherapy · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 9 institutions in 4 countries.
Funding
Abstract
backgroundThis drug resistance analysis of a randomized trial includes 234 patients receiving maribavir and 116 receiving investigator-assigned standard therapy (IAT), where 56% and 24%, respectively, cleared cytomegalovirus DNA at week 8 (treatment responders).
methodsBaseline and posttreatment plasma samples were tested for mutations conferring drug resistance in viral genes UL97, UL54, and UL27.
resultsAt baseline, genotypic testing revealed resistance to ganciclovir, foscarnet, or cidofovir in 56% of patients receiving maribavir and 68% receiving IAT, including 9 newly phenotyped mutations. Among them, 63% (maribavir) and 21% (IAT) were treatment responders. Detected baseline maribavir resistance mutations were UL27 L193F (n = 1) and UL97 F342Y (n = 3). Posttreatment, emergent maribavir resistance mutations were detected in 60 (26%) of those randomized to maribavir, including 49 (48%) of 103 nonresponders and 25 (86%) of the 29 nonresponders where viral DNA initially cleared then rebounded while on maribavir. The most common maribavir resistance mutations were UL97 T409M (n = 34), H411Y (n = 26), and C480F (n = 21), first detected 26 to 130 (median 56) days after starting maribavir.
conclusionsBaseline maribavir resistance was rare. Drug resistance to standard cytomegalovirus antivirals did not preclude treatment response to maribavir. Rebound in plasma cytomegalovirus DNA while on maribavir strongly suggests emerging drug resistance. CLINICAL TRIALS REGISTRATION: NCT02931539.
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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.