Cytomegalovirus (CMV) infection is a rare disease that occurs in humans. Once a person gets infected, the virus remains latent and may reactivate occasionally. Maribavir is a benzimidazole riboside drug with activity against CMV. This study aims to evaluate the efficacy and safety of maribavir for preemptive treatment of cytomegalovirus reactivation.

This is an open-label, dose-blinded trial, including a total of 156 patients who had received hematopoietic-cell or solid-organ transplants. The participants were randomly assigned to receive maribavir at a dose of 400, 800, and 1,200 mg twice a day or the standard dose of valganciclovir for 12 weeks. The primary outcome was the response to treatment confirmed by CMV DNA detection in plasma.

Out of 156 patients, 117 were assigned to the maribavir group and 39 to the valganciclovir group. Within 3 weeks, 62% of patients in the maribavir group and 56% in the valganciclovir group showed a response to the treatment. Within 6 weeks, 79% and 67% of the patients, respectively, showed a response to the treatment. 

The research concluded that the minimum dose of 400 mg maribavir twice daily had slightly better efficacy than the valganciclovir for clearing CMV viremia among patients who had received hematopoietic-cell or solid-organ transplants.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa1714656