2010
DOI: 10.1111/j.1600-6143.2010.03074.x
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The Efficacy and Safety of 200 Days Valganciclovir Cytomegalovirus Prophylaxis in High‐Risk Kidney Transplant Recipients

Abstract: Late-onset cytomegalovirus (CMV) disease is a significant problem with a standard 3-month prophylaxis regimen. This multicentre, double-blind, randomized controlled trial compared the efficacy and safety of 200 days' versus 100 days' valganciclovir prophylaxis (900 mg once daily) in 326 high-risk (D+/R-) kidney allograft recipients. Significantly fewer patients in the 200-day group versus the 100-day group developed confirmed CMV disease up to month 12 posttransplant (16.1% vs. 36.8%; p < 0.0001). Confirmed CM… Show more

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Cited by 445 publications
(446 citation statements)
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“…CMV disease incidence was 16.9% in high-risk patients (CMV Dþ/RÀ) and 4.4% in the intermediate-risk patients (CMV Rþ). These numbers are similar to or lower than those observed in the most recent published prospective cohort studies (9,26) or randomized controlled trials (15,16,27), reflecting the improved management on the prevention of CMV disease over the last years. Some patients took sequentially more than one drug, so the addition of numbers may result in >100%.…”
Section: Discussionmentioning
confidence: 43%
See 1 more Smart Citation
“…CMV disease incidence was 16.9% in high-risk patients (CMV Dþ/RÀ) and 4.4% in the intermediate-risk patients (CMV Rþ). These numbers are similar to or lower than those observed in the most recent published prospective cohort studies (9,26) or randomized controlled trials (15,16,27), reflecting the improved management on the prevention of CMV disease over the last years. Some patients took sequentially more than one drug, so the addition of numbers may result in >100%.…”
Section: Discussionmentioning
confidence: 43%
“…First, a significant number of patients (approximately 20-30% of Dþ/RÀ patients) may still develop CMV disease after discontinuation of prophylaxis (15,16). This is termed ''late-onset CMV disease'' and some studies suggest that it remains associated with poor outcomes in SOT recipients (17,18).…”
Section: Introductionmentioning
confidence: 99%
“…CMV incidence remains elevated in these patients, at between 16% and 37%, depending on the duration of preventive therapy (1,2). In one study directly comparing prophylactic and preemptive approaches, it was clearly demonstrated that late DNAemia occurs much more frequently in the prophylactic versus the preemptive setting (3,4).…”
Section: Introductionmentioning
confidence: 99%
“…The ease of prophylaxis treatment and the documented benefits in term of mortality is counterbalanced by the potential side effects, such as cytopenia and the occurrence of late-onset CMV disease. A longer period of prophylaxis (6 months) has been shown to further reduce late-onset CMV disease [1], but increased costs are an issue. Important considerations are the indirect effects of CMV on transplant-related endpoints, such as rejection and long-term graft function, which are linked to CMV by circumstantial evidence.…”
Section: Discussionmentioning
confidence: 99%
“…It has recently been shown that high-risk (D?/R-) kidney allograft recipients who receive prolonged prophylaxis for 6 months have a lower rate of CMV disease, although late-onset CMV disease still manifests in 16 % of the high-risk recipients [1]. In a similar study performed in high-risk kidney transplant recipients in Europe, 37 % of the investigated patients developed a CMV infection, and the majority were symptomatic after 6 months of valganciclovir prophylaxis [2].…”
Section: Introductionmentioning
confidence: 99%