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. 2019 Feb 26;63(3):e02337-18.
doi: 10.1128/AAC.02337-18. Print 2019 Mar.

Use of Letermovir as Salvage Therapy for Drug-Resistant Cytomegalovirus Retinitis

Nicholas Turner  1   2 , Andrew Strand  3   4 , Dilraj S Grewal  5 , Gary Cox  3 , Sana Arif  3 , Arthur W Baker  3   2 , Eileen K Maziarz  3 , Jennifer H Saullo  3 , Cameron R Wolfe  1
Affiliations

Use of Letermovir as Salvage Therapy for Drug-Resistant Cytomegalovirus Retinitis

Nicholas Turner et al. Antimicrob Agents Chemother. .

Abstract

Treatment options for drug-resistant cytomegalovirus (CMV) are limited. Letermovir is a novel antiviral recently approved for CMV prophylaxis following hematopoietic cell transplantation, but its efficacy in other settings is unknown. We recently used letermovir for salvage treatment in four solid organ transplant recipients with ganciclovir-resistant CMV retinitis. All patients improved clinically without known adverse drug events. However, three patients failed to maintain virologic suppression, including two patients who developed genotypically confirmed resistance to letermovir while on therapy.

Keywords: cytomegalovirus; ganciclovir-resistant; letermovir.

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Figures

FIG 1
FIG 1
CMV Plasma DNAemia response kinetics on letermovir treatment. Horizontal lines above each graph represent the time period on systemic therapy with each agent. Vertical tick marks indicate intravitreal doses. The horizontal dashed line indicates the threshold for quantitative detection of CMV plasma DNA by the assays used in this series (137 IU/ml). The vertical dashed line indicates timing of letermovir drug resistance testing.
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