Ganciclovir Exposure under a 450 mg Daily Dosage of Valganciclovir for the Prevention of Cytomegalovirus Disease in Kidney Transplant Recipients.

Détails

ID Serval
serval:BIB_18DA47E61C5B
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Titre
Ganciclovir Exposure under a 450 mg Daily Dosage of Valganciclovir for the Prevention of Cytomegalovirus Disease in Kidney Transplant Recipients.
Titre de la conférence
9th Joint Meeting of the American Society of Transplant Surgeon and of the American Society of Transplantation
Auteur(s)
Manuel Oriol, Pascual Manuel, Perrottet Nancy, Lamoth Frederic, Venetz Jean-Pierre, Decosterd Laurent, Buclin Thierry, Meylan Pascal R.
Adresse
Boston, Massachusetts, May 30-June 3, 2009
ISBN
1600-6135
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
9
Série
American Journal of Transplantation
Pages
249
Langue
anglais
Notes
Publication type : Meeting Abstract
Résumé
Background: It is suggested that a low dose of valganciclovir can be equally
effective than a standard dose for cytomegalovirus (CMV) prophylaxis after kidney
transplantation. The aim of our study was to determine the ganciclovir exposure
observed under a routine daily dosage of 450 mg valganciclovir in kidney transplant
recipients with a wide range of renal function.
Methods: In this prospective study, kidney transplant recipients with a GFR MDRD
above 25 mL/min at risk for CMV (donor or recipient seropositive for CMV) received
a dose of valganciclovir (450 mg daily) prophylaxis for 3 months. Ganciclovir
levels at trough (Ctrough) and at peak (C3h) were measured monthly. Ganciclovir
exposure (AUC0-24) was estimated using Bayesian non-linear mixed-effect modelling
(NONMEM) and compared between 3 groups of patients according to their kidney
function: GFRMDRD 26-39 mL/min (Group 1), GFRMDRD 40-59 mL/min (Group 2)
and GFRMDRD 60-90 mL/min (Group 3). CMV DNAemia was assessed during and
after prophylaxis using PCR.
Results: Thirty-six patients received 450 mg daily of valganciclovir for 3 months.
Median ganciclovir C3h was 3.9 mg/L (range: 1.3-7.1) and Ctrough was 0.4 mg/L (range
0.1-2.7). Median (range) AUC0-24 of ganciclovir was 59.3 mg.h/L (39.0-85.3) in
Group 1 patients, 35.8 mg.h/L (24.9-55.8) in Group 2 patients and 29.6 mg.h/L (22.0-
43.2) in Group 3 patients (p<0.001). Anemia was more common in Group 1 patients
compared to patients on the other groups (p=0.01). No differences in other adverse
events according to ganciclovir exposure were observed. CMV DNAemia was not
detected during prophylaxis. After discontinuing prophylaxis, CMV DNAemia was
seen in 8/34 patients (23.5%) and 4/36 patients (11%) developed CMV disease.
Conclusion: A routine dosage of valganciclovir achieved plasma levels of ganciclovir
in patients with GFR>60 mL/min similar to those previously reported using oral
ganciclovir. A daily dose of 450 mg valganciclovir appears to be acceptable for
CMV prophylaxis in most kidney transplant recipients.
Web of science
Création de la notice
27/07/2010 15:34
Dernière modification de la notice
20/08/2019 12:49
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