Evidence map›Paper›PMID 39427300›Full record

Observational studyClinical transplantation2024

Evaluating Real-World Experience With Maribavir for Treatment of Refractory/Resistant Cytomegalovirus in Renal Transplant Recipients.

Vivek B Beechar, Varun K Phadke, Stephanie M Pouch, Aneesh K Mehta, Geeta Karadkhele, Christian P Larsen, Michael H Woodworth

Abstract readObservational Study
In one paragraph

Observational study in Clinical transplantation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Use of Maribavir in Adult Patients With Post-Transplant Refractory Cytomegalovirus Infection in the Real-Life Setting.Transplant international : official journal of the European Society for Organ Transplantation · 2026
    Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Vivek B BeecharDivision of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID 0000-0003-1803-9520
Varun K PhadkeDivision of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Stephanie M PouchDivision of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Aneesh K MehtaDivision of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Geeta KaradkheleDivision of Transplantation, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Christian P LarsenDivision of Transplantation, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Michael H WoodworthDivision of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.

Funding

Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
J: NRSA Training CoreTL1TR002382 · NCATS · EMORY UNIVERSITY · PI HENRY M BLUMBERG, Vasiliki Michopoulos · 2017 to 2026
$8.5M
Temporal dynamics of MDRO eradication after FMTK23AI144036 · NIAID · EMORY UNIVERSITY · PI WOODWORTH, MICHAEL HOLMES · 2019 to 2023
$957k
National Institute of Allergy and Infectious Diseases K23AI144036NCATS NIH HHS TL1 TR002382NCATS NIH HHS UL1 TR002378NIAID NIH HHS K23 AI144036NIH HHS TL1TR002382NIH HHS UL1TR002378
6 · The paper itself

Abstract

introductionMaribavir was recently approved by the FDA, expanding treatment options for post-solid-organ transplant refractory/resistant CMV. We sought to describe the post-marketing experience with maribavir at a large academic transplant center.

methodsThis was a retrospective observational study of all renal transplant recipients treated with maribavir for refractory/resistant CMV DNAemia/disease. CMV viral loads, immunosuppression regimens and management, resistance testing, and antiviral therapy durations were reviewed. Outcomes of interest included treatment success, defined as undetectable CMV DNAemia for two consecutive weeks or detected but unquantifiable DNAemia for five consecutive weeks, as well as the emergence of antiviral resistance, and recurrent DNAemia.

resultsFrom 2021 to 2023, 5/10 (50%) patients achieved durable virologic suppression with maribavir (classified as responders). Among responders, 2/5 (40%) experienced low-level CMV DNAemia recurrence (defined as a viral load less than 1000 IU/mL) within 8 weeks of antiviral discontinuation. Among nonresponders, 2/3 (66.7%) were found to have UL97 protein mutations associated with maribavir resistance identified 85 and 75 days after initiation of maribavir. Two patients are currently on maribavir with clinical outcomes that are yet to be determined. Responders had a mean reduction of 200 mg (SD-274 mg) in mycophenolate dosing with nonresponders having a mean increase of 167 mg (SD-764 mg).

conclusionsMaribavir, often in conjunction with mycophenolate dose reduction, was effective for many patients with refractory/resistant CMV DNAemia at our transplant center, though several experienced recurrent DNAemia. In patients who did not respond to therapy, resistance to maribavir was frequently detected. Clinicians treating these patients should remain vigilant for rebound CMV DNAemia and consider repeat antiviral resistance testing.

Indexed as

Antiviral AgentsBenzimidazolesCytomegalovirusCytomegalovirus InfectionsDrug Resistance, ViralKidney TransplantationRibonucleosidesAdultAgedDichlororibofuranosylbenzimidazoleFemaleFollow-Up StudiesGraft RejectionGraft SurvivalHumansMaleAntiviral AgentsBenzimidazolesDichlororibofuranosylbenzimidazolemaribavirRibonucleosidesCMVrefractory/resistantrenal transplant recipients

Identifiers

PMID39427300
PMCPMC11889418

What OpenQuestion holds

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Registered trials

None linked

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.