Actively Recruiting

Phase 2
Age: 18Years - 70Years
All Genders
ID05432778

Cytomegalovirus Prophylaxis With Letermovir in Heart Transplant Recipients: A Non-randomized Cohort Pilot Study

Led by University Medical Centre Ljubljana · Updated on 2023-11-09

90

Participants Needed

1

Research Sites

52 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Cytomegalovirus (CMV) infection is a common complication after heart transplantation, affecting up to 40-60% of recipients, usually within the first six months. While often asymptomatic, CMV can cause serious illness and increase risks like graft loss, cancers, and infections. This study aims to evaluate the effects of letermovir, a newer antiviral drug, for CMV prevention in heart transplant patients, as it has shown promise with fewer side effects in other transplant types. This Phase II pilot study will enroll 30 new heart transplant recipients who will receive letermovir as CMV prophylaxis. The drug will be given orally at 240 mg or 480 mg once daily, starting between days 4 and 7 post-transplant. The duration of treatment will be guided by blood tests measuring CMV immune response and viral load. A control group of 60 matched patients will receive the standard valgancyclovir treatment. Both groups will also receive standard immunosuppression and prophylaxis for fungal and pneumocystis infections. Participants will be monitored monthly for 12 months after enrollment, with evaluations including CMV infection rates, immune function tests, and side effect assessments like blood counts. If CMV infection occurs, treatment with valgancyclovir or gancyclovir will be given. After the study, patients still needing CMV prophylaxis will switch to standard care. The study will assess how well letermovir prevents CMV and its tolerability in heart transplant patients.

CONDITIONS

Brief Title

Cytomegalovirus Prophylaxis With Letermovir in Heart Transplant Recipients

Who Can Participate

Age: 18Years - 70Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • New heart transplant recipient
  • Moderate or high risk CMV serostatus (D+/R+, D-/R+, or D+/R-)
  • Signed informed consent for participation
Not Eligible

You will not qualify if you...

  • Short-term mechanical circulatory support before heart transplant
  • Current active CMV infection or disease
  • CMV serostatus D-/R-
  • Heart re-transplantation
  • Need for intensified immunosuppression protocol
  • More than 20% cytolytic alloantibodies before transplant
  • Allograft rejection greater than 1R within 7 days after transplant
  • Immunoinduction with ATG
  • Pregnancy
  • Active participation in another interventional clinical trial
  • Known allergy to letermovir
  • Known allergy to valgancyclovir
  • Known blood disorders other than anemia

AI-Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - Up to 12 months

Participants receive virostatic prophylaxis with letermovir starting between days 4 and 7 after heart transplantation. The duration of prophylaxis is determined by the Quantiferon-CMV assay results and may continue up to 12 months.

Monthly outpatient visits for 12 months

Trial Site Locations

Total: 1 location

1

University Medical Center Ljubljana

Ljubljana, Slovenia, 1000

Actively Recruiting

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Research Team

B

Bojan Vrtovec, MD, PhD

G

Gregor Poglajen, MD, PhD

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

NON_RANDOMIZED

Model

PARALLEL

Primary Purpose

PREVENTION

Number of Arms

2

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