Letermovir breakthroughs during the French Named Patient Programme: interest of monitoring blood concentration in clinical practice. (15th May 2020)

• Record Type: Journal Article
• Authors: Alain, S; Feghoul, L; Girault, S; Lepiller, Q; Frobert, E; Michonneau, D; Berceanu, A; Ducastelle-Lepretre, S; Tilloy, V; Guerin, E; Le Goff, J; Peytavin, G; Hantz, S
• Is Part Of: Journal of antimicrobial chemotherapy. Volume 75:Number 8(2020)
• Page Start: 2253
• Page End: 2257
• Publication Date: 2020-05-15
• Subjects: Anti-infective agents -- Periodicals; Chemotherapy -- Periodicals; 615.58
• DOI: 10.1093/jac/dkaa135
• Languages: English
• ISSNs: 0305-7453

Abstract

Abstract: Objectives: To analyse mechanisms of letermovir breakthrough during compassionate primary and secondary prophylaxis. Methods: 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. Results: 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. Conclusions: Measurement of letermovir concentration and genotyping should be recommended for patient follow-up during letermovir therapy.