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Valganciclovir for Cytomegalovirus Prevention in Solid Organ Transplant Patients: An Evidence-Based Reassessment of Safety and Efficacy

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  • Andre C Kalil
  • Alison G Freifeld
  • Elizabeth R Lyden
  • Julie A Stoner

Abstract

Background: Several anti-viral drugs have demonstrated efficacy in preventing Cytomegalovirus (CMV) infections in solid organ transplant (SOT) patients. The recently approved valganciclovir is the most commonly used and most expensive drug for CMV prevention. The safety and efficacy data have been drawn from a single trial. We hypothesized that valganciclovir may not be as safe as nor more effective than other therapies for CMV prevention. Methods: All experimental and analytical studies that compared valganciclovir with other therapies for prevention of CMV infection after SOT were selected. Based on meta-analytic and multivariate regression methodologies we critically analyzed all available evidence. Findings: Nine studies were included (N = 1,831). In trials comparing valganciclovir with ganciclovir, the risk for CMV disease is 0.98 (95% Confidence Interval (95%CI) 0.67 to 1.43; P = 0.92; I2 = 0%). Valganciclovir was significantly associated with the risk of absolute neutropenia (

Suggested Citation

  • Andre C Kalil & Alison G Freifeld & Elizabeth R Lyden & Julie A Stoner, 2009. "Valganciclovir for Cytomegalovirus Prevention in Solid Organ Transplant Patients: An Evidence-Based Reassessment of Safety and Efficacy," PLOS ONE, Public Library of Science, vol. 4(5), pages 1-10, May.
    • Handle: RePEc:plo:pone00:0005512
    DOI: 10.1371/journal.pone.0005512
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    1. Unknown, 2000. "Table of Contents," 2000 Conference, August 13-18, 2000, Berlin, Germany 274812, International Association of Agricultural Economists.
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