What is it about?
Valganciclovir is the most popular drug used in cytomegalovirus prophylaxis. We have shown that valganciclovir is not more effective than the alternative drug (valacyclovir) in prevention of cytomegalovirus viremia in kidney transplant recipients. However, less acute rejection episodes was observed with valganciclovir. Increased incidence of polyoma BK virus viremia in valganciclovir group is of concern.
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Why is it important?
This is the first RCT comparing valganciclovir and valacyclovir prophylaxis is kidney transplantation. The findings of lower rejection but higher polyomavirus viremia support the hypothesis of immunosuppressive properties of valganciclovir.
Perspectives
Further research should confirm or exclude a clinically significant immunosuppressive effect of valganciclovir. The longterm results of the study will answer if the early differences between both drugs pose different patient and graft outcomes such as graft survival, graft function, the level of fibrosis in graft biopsies..).
Prof Tomas Reischig
Charles University Medical School and Teaching Hospital
Read the Original
This page is a summary of: Randomized Trial of Valganciclovir Versus Valacyclovir Prophylaxis for Prevention of Cytomegalovirus in Renal Transplantation, Clinical Journal of the American Society of Nephrology, November 2014, American Society of Nephrology,
DOI: 10.2215/cjn.07020714.
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