Ganciclovir exposure under a 450 mg daily dosage of valganciclovir for cytomegalovirus prevention in kidney transplantation: a prospective study.

Détails

ID Serval
serval:BIB_F844F8046356
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Ganciclovir exposure under a 450 mg daily dosage of valganciclovir for cytomegalovirus prevention in kidney transplantation: a prospective study.
Périodique
Clinical transplantation
Auteur(s)
Manuel O., Pascual M., Perrottet N., Lamoth F., Venetz J.P., Decosterd L.A., Buclin T., Meylan P.R.
ISSN
1399-0012 (Electronic)
ISSN-L
0902-0063
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
24
Numéro
6
Pages
794-800
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
This prospective study aimed at determining the ganciclovir exposure observed under a daily dosage of 450 mg valganciclovir routinely applied to kidney transplant recipients with a GFR above 25 mL/min at risk for cytomegalovirus (CMV) disease. Ganciclovir levels at trough (C(trough)) and at peak (C₃(h)) were measured monthly. Ganciclovir exposure (area under the curve [AUC₀₋₂₄]) was estimated using Bayesian non-linear mixed-effect modeling (NONMEM). Thirty-six patients received 450 mg of valganciclovir daily for three months. Median ganciclovir C₃(h) was 3.9 mg/L (range: 1.3-7.1), and C(trough) was 0.4 mg/L (range 0.1-2.7). Median AUC₀₋₂₄ of ganciclovir was 59.3 mg h/L (39.0-85.3) in patients with GFR(MDRD) 26-39 mL/min, 35.8 mg h/L (24.9-55.8) in patients with GFR(MDRD) 40-59 mL/min, and 29.6 mg h/L (22.0-43.2) in patients with GFR(MDRD) ≥ 60 mL/min. No major differences in adverse events according to ganciclovir exposure were observed. CMV viremia was not detected during prophylaxis. After discontinuing prophylaxis, CMV viremia was seen in 8/36 patients (22%), and 4/36 patients (11%) developed CMV disease. Ganciclovir exposure after administration of valganciclovir 450 mg daily in recipients with GFR ≥ 60 mL/min was comparable to those previously reported with oral ganciclovir. A routine daily dose of 450 mg valganciclovir appears to be acceptable for CMV prophylaxis in most kidney transplant recipients.
Mots-clé
Adult, Aged, Antiviral Agents/administration & dosage, Cytomegalovirus/drug effects, Cytomegalovirus Infections/prevention & control, Cytomegalovirus Infections/virology, Female, Ganciclovir/administration & dosage, Ganciclovir/analogs & derivatives, Glomerular Filtration Rate, Humans, Kidney Transplantation, Male, Middle Aged, Prospective Studies, Survival Rate, Tissue Distribution, Valganciclovir
Pubmed
Web of science
Création de la notice
04/10/2019 8:00
Dernière modification de la notice
05/10/2019 6:26
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