Article: Similar reduction of cytomegalovirus DNA load by oral valganciclovir and intravenous ganciclovir on pre-emptive therapy after renal and renal-pancreas transplantation.
2005 Volume 10, Issue 1, Page(s) 119–123
Abstract: Background: Pre-emptive treatment of CMV infection in transplant recipients aims at prevention of clinical disease by early detection. However, current treatment requires the intravenous (iv) administration of ganciclovir for 2 weeks, which is a ... ...
| Abstract | Background: Pre-emptive treatment of CMV infection in transplant recipients aims at prevention of clinical disease by early detection. However, current treatment requires the intravenous (iv) administration of ganciclovir for 2 weeks, which is a considerable burden for the patient. In this observational study, the efficacy of the new oral prodrug valganciclovir was compared with iv ganciclovir. Methods: To facilitate the introduction of valganciclovir, a therapeutic guideline was developed to use this drug under controlled conditions with regard to safety in renal/renal-pancreas transplant recipients requiring CMV therapy. Subsequently, a group of 57 consecutive transplant recipients was evaluated. Onset and treatment of CMV infections were followed by frequent monitoring of CMV DNA in plasma by quantitative real-time PCR. Details of antiviral therapy were documented. Results: In 15 out of 57 transplant recipients, a total of 27 anti-CMV treatment episodes were recorded: 18 with valganciclovir (900 mg twice daily) and nine with iv ganciclovir (5 mg/kg twice daily) as initial treatment. Median CMV DNA load reduction during treatment was 0.12 log10/day in the valganciclovir group and 0.09 log10/day in the ganciclovir group. There were no haematological side effects in any group and no patient developed signs of clinical CMV disease. Conclusion: Similar reduction of CMV DNA load was observed during pre-emptive treatment with oral valganciclovir and iv ganciclovir in transplant recipients. Oral valganciclovir would provide an attractive and safe alternative for pre-emptive CMV treatment in renal/renal-pancreas transplant patients, however, confirmation in larger randomized studies would be desirable. |
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| MeSH term(s) | Administration, Oral ; Adult ; Aged ; Antiviral Agents/administration & dosage ; Cytomegalovirus/drug effects ; Cytomegalovirus/genetics ; Cytomegalovirus Infections/drug therapy ; Cytomegalovirus Infections/prevention & control ; Cytomegalovirus Infections/virology ; DNA, Viral/blood ; DNA, Viral/genetics ; Female ; Ganciclovir/administration & dosage ; Ganciclovir/analogs & derivatives ; Humans ; Injections, Intravenous ; Kidney Transplantation/adverse effects ; Male ; Middle Aged ; Opportunistic Infections/drug therapy ; Opportunistic Infections/prevention & control ; Opportunistic Infections/virology ; Pancreas Transplantation/adverse effects ; Safety | ||||||||||
| Chemical Substances | Antiviral Agents ; DNA, Viral ; valganciclovir (GCU97FKN3R) ; Ganciclovir (P9G3CKZ4P5) | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2005 | ||||||||||
| Publishing country | England | ||||||||||
| Document type | Clinical Trial ; Comparative Study ; Journal Article | ||||||||||
| ZDB-ID | 1339842-8 | ||||||||||
| ISSN | 1359-6535 | ||||||||||
| ISSN | 1359-6535 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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