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There is no consensus regarding the appropriate treatment regimen for resistant/refractory CMV. Currently available systemic anti-CMV agents include IV or oral ganciclovir, oral valganciclovir, IV foscarnet, and IV cidofovir. While these agents are considered effective, their use is limited by their respective toxicities, most notably bone marrow suppression caused by ganciclovir/valganciclovir and renal impairment caused by foscarnet or cidofovir. Maribavir is a potent and selective, orally bioavailable antiviral drug. Current anti-CMV agents inhibit CMV DNA polymerase. Maribavir inhibits viral DNA assembly as well as egress of viral capsids from the nucleus of infected cells. In vitro assays show 3- to 20-fold more activity than ganciclovir and cidofovir, and at least 100-fold more activity than foscarnet. Maribavir is active in vitro against strains of CMV that are resistant to ganciclovir, foscarnet, or cidofovir. Maribavir was safe and well tolerated across the range of doses tested in Phase 1 (up to 2400 mg/day for 28 days). Taste disturbance, nausea, and diarrhea were the most common drug-related AE. In a Phase 2 study of 82 subjects, prophylaxis with maribavir at all doses studied reduced the rate of CMV reactivation compared to the placebo.