Letermovir Prophylaxis for Cytomegalovirus Infection in Heart Transplant Recipients

No longer recruiting at 1 trial location
JK
DR
Overseen ByDavid R Snydman, MD
Age: 18+
Sex: Any
Trial Phase: Phase 4
Sponsor: Tufts Medical Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests letermovir (Prevymis) to prevent cytomegalovirus (CMV) infections in heart transplant patients at risk of CMV. Researchers aim to assess the drug's effectiveness and patient tolerance, particularly regarding side effects like neutropenia (a drop in white blood cells). The trial compares new data from 30 patients with past data from 374 transplant recipients. Heart transplant recipients who are not CMV donor and recipient negative may be suitable for this study. As a Phase 4 trial, this research focuses on understanding how the already FDA-approved and effective treatment benefits more patients.

Do I have to stop taking my current medications for this trial?

The trial information does not specify if you need to stop taking your current medications. It's best to discuss this with the study team or your doctor to get a clear answer.

What is the safety track record for letermovir?

Research has shown that letermovir is already approved to prevent cytomegalovirus (CMV) in individuals who have undergone certain transplants, such as kidney and stem cell transplants. This indicates it is generally safe and well-tolerated in these groups. Studies suggest it could also be a safe and effective option for preventing CMV infections in heart transplant patients.

This trial is in Phase 4, indicating that letermovir has already undergone safety testing in earlier phases. Phase 4 focuses more on the treatment's effectiveness and seeks to identify any rare side effects. Letermovir has passed many safety checks already. However, participants should report any side effects to the study team.12345

Why are researchers enthusiastic about this study treatment?

Letermovir is unique because it offers a targeted approach to preventing cytomegalovirus (CMV) infections in heart transplant recipients. Unlike current treatments like ganciclovir or valganciclovir, which can have significant side effects including bone marrow suppression, letermovir works by inhibiting the CMV DNA terminase complex, reducing the risk of these complications. Researchers are excited about letermovir because it has shown promise in being both effective and better tolerated, potentially leading to improved outcomes and quality of life for transplant patients.

What evidence suggests that letermovir is effective for preventing cytomegalovirus infection in heart transplant recipients?

Previous studies have shown that letermovir effectively prevents cytomegalovirus (CMV) infections in heart transplant patients. Specifically, 92.3% of patients completed their letermovir treatment without contracting CMV after their heart transplant. Research indicates that letermovir is generally well-tolerated and offers protection comparable to other treatments. This medication is already approved for preventing CMV, demonstrating its effectiveness in stopping these infections in individuals with weakened immune systems. In this trial, participants will receive letermovir as a single-arm treatment for CMV prophylaxis.24678

Are You a Good Fit for This Trial?

This trial is for adults aged 18-70 who have recently received a heart transplant and are at risk for cytomegalovirus, but not HIV positive or on dialysis. They mustn't be allergic to letermovir, participating in other clinical trials with investigational drugs, or planning to donate eggs/sperm within 90 days after the study.

Inclusion Criteria

I have signed the consent form and can attend all follow-up visits.
I had a heart transplant and either I or my donor was not CMV negative.
Not enrolled in competing clinical trials

Exclusion Criteria

Hypersensitivity to letermovir
Patients who do not survive 72 hours post transplant
My liver is not working well (severe issues).
See 14 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive letermovir 480 mg daily for CMV prophylaxis for either 3 or 6 months depending on CMV risk category

3-6 months

Follow-up

Participants are monitored for safety and effectiveness after treatment, including assessment of T cell immunity and adverse events

12 months

What Are the Treatments Tested in This Trial?

Interventions

  • Letermovir
Trial Overview The trial tests Letermovir as a preventive measure against CMV infection in heart transplant recipients. It compares outcomes of a new group of 30 patients with those from a past group of 374 patients, focusing on rates of neutropenia and drug tolerability.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: single armExperimental Treatment1 Intervention

Letermovir is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as Prevymis for:
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Approved in European Union as Prevymis for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Tufts Medical Center

Lead Sponsor

Trials
264
Recruited
264,000+

Merck Sharp & Dohme LLC

Industry Sponsor

Trials
4,096
Recruited
5,232,000+
Chirfi Guindo profile image

Chirfi Guindo

Merck Sharp & Dohme LLC

Chief Marketing Officer since 2022

Degree in Engineering from Ecole Centrale de Paris, MBA from New York University Stern School of Business

Robert M. Davis profile image

Robert M. Davis

Merck Sharp & Dohme LLC

Chief Executive Officer since 2021

JD from Northwestern University Pritzker School of Law, MBA from Northwestern University Kellogg Graduate School of Management, Bachelor's in Finance from Miami University

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/40562091/
Efficacy of Letermovir for Cytomegalovirus Prophylaxis in ...Results: A total of 52 patients received letermovir for an average of 8.2 months (range, 1-35 months). The average time from transplantation to ...
Efficacy of Letermovir for Cytomegalovirus Prophylaxis in ...Most patients, 92.3%, were able to complete letermovir therapy for CMV prophylaxis post–heart transplantation. ABSTRACT. Background.
Tolerability and clinical efficacy of letermovir for primary ...LET is well tolerated and shows comparable clinical effectiveness for primary CMV prophylaxis post-HT compared to a historical, predominantly ...
Cytomegalovirus infection in heart transplant recipientsThis study analyzes the rates, risk factors, and outcomes of CMV among heart transplant recipients.
Letermovir vs Valganciclovir for Prophylaxis of ...This randomized clinical trial compares the efficacy and safety of letermovir vs valganciclovir prophylaxis for cytomegalovirus (CMV) ...
De Novo Letermovir for Cytomegalovirus Primary ...Currently, letermovir is approved for CMV prophylaxis in hematopoietic cell and kidney transplant recipients, but not for heart transplant ...
Cytomegalovirus Prophylaxis With Letermovir in Heart ...CMV infection is the most prevalent infection after heart transplantation (HTX), occurring in up to 40-60% of the recipients. It most frequently occurs ...
Use of Letermovir for Cytomegalovirus (CMV) Prophylaxis ...Letermovir has been approved for CMV prophylaxis in adult hematopoietic stem cell transplant patients, however there is a paucity of data on the use of ...
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