Pharmacokinetic drug evaluation of letermovir prophylaxis for cytomegalovirus in hematopoietic stem cell transplantation.

Abstract

INTRODUCTION:

Letermovir is a new antiviral approved to prevent cytomegalovirus infection in hematopoietic stem cell transplant recipients. It has a distinct mechanism of action as it acts as a terminase complex inhibitor, and shows some advantages compared to the current treatment options for cytomegalovirus infection. Areas covered: This review focuses on the efficacy, safety, pharmacokinetics, pharmacodynamics, and drug-drug interactions of letermovir. Expert opinion: Letermovir is a new antiviral to prevent cytomegalovirus infection. Unlike the currently used polymerase inhibitors, it has a distinct mechanism of action with better safety, limited resistance, and no cross-resistance. Although a lot of research on pharmacokinetics and drug-drug interactions has already been performed, it might be useful to clarify the effect of letermovir on voriconazole exposure, the drug-drug interaction between caspofungine and letermovir and the effect of statins on letermovir exposure. Also, the lack of an exposure-response relationship should be confirmed in large real-life post-marketing studies in order to be able to lower the intravenous dose of letermovir.

• Authors: Barbara Deleenheer, Isabel Spriet, Johan Maertens
• Journal: Expert opinion on drug metabolism & toxicology (Expert Opin Drug Metab Toxicol) Vol. 14 Issue 12 Pg. 1197-1207 (Dec 2018) ISSN: 1744-7607 [Electronic] England
• PMID: 30479172 (Publication Type: Journal Article, Review)

Chemical References

• Acetates
• Antiviral Agents
• Quinazolines
• letermovir

Topics

• Acetates (administration & dosage, pharmacokinetics, pharmacology)
• Antiviral Agents (administration & dosage, pharmacokinetics, pharmacology)
• Cytomegalovirus
• Cytomegalovirus Infections (etiology, prevention & control)
• Drug Interactions
• Drug Resistance, Viral
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Quinazolines (administration & dosage, pharmacokinetics, pharmacology)