Everolimus is associated with a reduced incidence of cytomegalovirus infection following de novo cardiac transplantation

Background Cytomegalovirus (CMV) causes several complications following cardiac transplantation including cardiac allograft vasculopathy. Previous studies suggested that immunosuppressive treatment based on everolimus might reduce CMV infection. Aiming to better characterize the action of everolimus...

Full description

Saved in:
Bibliographic Details
Published in:Transplant infectious disease 2013-04, Vol.15 (2), p.150-162
Main Authors: Kobashigawa, J., Ross, H., Bara, C., Delgado, J.F., Dengler, T., Lehmkuhl, H.B., Wang, S.-S., Dong, G., Witte, S., Junge, G., Potena, L.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
antiviral
Azathioprine - therapeutic use
cardiac transplantation
Cyclosporine - therapeutic use
Cytomegalovirus
Cytomegalovirus - isolation & purification
Cytomegalovirus Infections - epidemiology
Cytomegalovirus Infections - prevention & control
Drug Therapy, Combination
Everolimus
Female
Heart Transplantation
Humans
Immunosuppressive Agents - therapeutic use
Incidence
Male
Middle Aged
mTOR inhibitor
Postoperative Complications - prevention & control
Sirolimus - analogs & derivatives
Sirolimus - therapeutic use
Statistics as Topic
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Cytomegalovirus (CMV) causes several complications following cardiac transplantation including cardiac allograft vasculopathy. Previous studies suggested that immunosuppressive treatment based on everolimus might reduce CMV infection. Aiming to better characterize the action of everolimus on CMV and its interplay with patient/recipient serology and anti‐CMV prophylaxis, we analyzed data from 3 large randomized studies comparing various everolimus regimens with azathioprine (AZA)‐ and mycophenolate mofetil (MMF)‐based regimens. Methods CMV data were analyzed from 1009 patients in 3 trials of de novo cardiac transplant recipients who were randomized to everolimus 1.5 mg/day, everolimus 3 mg/day, or AZA 1–3 mg/kg/day, plus standard‐dose (SD) cyclosporine (CsA; study B253, n = 634); everolimus 1.5 mg/day plus SD‐ or reduced‐dose (RD)‐CsA (study A2403, n = 199); and everolimus 1.5 mg/day plus RD‐CsA or MMF plus SD‐CsA (study A2411, n = 176). Results In study B253, patients allocated to everolimus experienced almost a 70% reduction in odds of experiencing CMV infection compared with AZA (P 
ISSN:1398-2273
1399-3062
DOI:10.1111/tid.12007