#VisualAbstract: Maribavir for Preemptive Treatment of Cytomegalovirus Reactivation

1. This phase 2, parallel-group randomized control trial compared the safety and efficacy profile of maribavir versus valgancicvlovir among patients who received solid organ transplants, finding that both medications had comparable efficacy profiles in preventing CMV infection within 6 weeks of starting therapy.

2. Patients randomized to receive maribavir had a higher incidence of adverse events, with the most common adverse event noted to be dysgeusia and gastrointestinal-related symptoms.

Evidence Rating Level: 1 (Excellent)  

Study Rundown: Cytomegalovirus (CMV) infection is a potential concern among patients who have undergone solid organ transplantation. Current medications that are approved to prevent or treat CMV infection have toxic side effects such as myelosuppression, nephrotoxicity and electrolyte imbalances. Maribavir, a selective benzimidazole riboside, is a new medication that is being studied as a potential treatment for CMV infection prophylaxis. Maribavir prevents the exit of viral capsids from the cell nucleus by inhibiting CMV protein kinase UL97. In this phase 2 analysis, researchers compared the safety and efficacy profile of maribavir as compared to valganciclovir among patients who had received hematopoetic-cell or solid organ transplantation. Overall, researchers found that both regimens had similar efficacies in treating and preventing CMV infection. Patients randomized to receive maribavir had a higher incidence of gastrointestinal-related adverse events including dysgeusia. Patients randomized to receive valganciclovir had a higher incidence of neutropenia during the study period. Overall this study indicates that more research is warranted to evaluate maribavir and its treatment efficacy for this patient population.

Click to read the study in NEJM