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- Title
Letermovir breakthroughs during the French Named Patient Programme: interest of monitoring blood concentration in clinical practice.
- Authors
Alain, S; Feghoul, L; Girault, S; Lepiller, Q; Frobert, E; Michonneau, D; Berceanu, A; Ducastelle-Lepretre, S; Tilloy, V; Guerin, E; Goff, J Le; Peytavin, G; Hantz, S; Le Goff, J
- Abstract
<bold>Objectives: </bold>To analyse mechanisms of letermovir breakthrough during compassionate primary and secondary prophylaxis.<bold>Methods: </bold>Mechanisms of letermovir breakthrough during compassionate primary and secondary prophylaxis were analysed in four patients from the French Named Patient Programme by the French National Reference Centre for Herpesviruses.<bold>Results: </bold>Of three absolute resistance cases, two were associated with treatment interruption or low letermovir concentrations in blood. A fourth case of breakthrough was not associated with resistance. Next-generation sequencing (NGS) genotyping confirmed rapid emergence of resistant mutants, within 3 months of treatment initiation.<bold>Conclusions: </bold>Measurement of letermovir concentration and genotyping should be recommended for patient follow-up during letermovir therapy.
- Subjects
NUCLEOTIDE sequencing; BLOOD; BLOOD coagulation factor VIII; CYTOMEGALOVIRUSES; RESEARCH; CYTOMEGALOVIRUS diseases; HETEROCYCLIC compounds; RESEARCH methodology; ANTIVIRAL agents; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; ACETIC acid
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2020, Vol 75, Issue 8, p2253
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkaa135