New CMV treatment option gains ground in transplant care

Cytomegalovirus (CMV) treatment is considered essential in clinical settings for patients who have undergone allogeneic hematopoietic stem cell transplantation and solid organ transplantation. CMV is a double-stranded DNA virus from the herpesvirus family, transmitted mainly through bodily fluids, white blood cells, and transplanted organs.

Though CMV infections are common among transplant patients, they pose a significant, potentially life-threatening risk, requiring proactive management.

Thankfully, the number of therapeutic options available in clinical practice has increased, improving patient access.

With the reimbursement of Takeda Korea's Livtencity (ingredient: maribavir), Korean doctors are embracing a new treatment option for CMV.

During a press conference organized by Takeda Korea on Tuesday, Professor Kim Sung-han of the Department of Infectious Diseases at Asan Medical Center, recently discussed the impact of this treatment.

"CMV infection remains a significant concern for transplant patients," Kim explained. "In Korea, it affects up to 88 percent of allogeneic stem cell transplant recipients and 55 percent of solid organ transplant recipients."

The herpes family virus, while often dormant in healthy individuals, poses severe risks to immunocompromised patients, Kim added.

If not properly managed, CMV can progress from a silent infection to a life-threatening disease, potentially triggering transplant rejection and other serious complications.

Kim said that Livtencity's inclusion in the reimbursement scheme has been a game-changer for allogeneic hematopoietic stem cell transplant patients who don't respond to or develop resistance against traditional treatments like ganciclovir and valganciclovir.

"The drug employs a unique mechanism to inhibit viral replication, showing twice the efficacy in clearing CMV from the bloodstream compared to existing options," he said. "Livtencity's oral formulation is a significant advantage as it allows for outpatient treatment, greatly improving the quality of life for these vulnerable patients."

However, Kim stressed the high cost of the medication continues to present challenges.

"While now covered by insurance for six months as a second-line treatment, some physicians report feeling pressure to curtail preventive therapies prematurely due to concerns about insurance claim rejections," Kim said. "There are also still unresolved issues in the treatment protocols between the hematology and infectious disease departments when it comes to managing CMV after allogeneic HSCT."

As a result, there is a need for updated treatment protocols, particularly for stem cell transplant recipients, Kim added.