As first-line treatment for patients with CLL, alemtuzumab demonstrated significantly improved PFS, time to alternative treatment, ORR and CR, and minimal residual disease-negative remissions compared with chlorambucil, with predictable and manageable toxicity.

Background Therapies for refractory cytomegalovirus infections (with or without resistance [R/R]) in transplant recipients are limited by toxicities. Maribavir has multimodal anti-cytomegalovirus activity through the inhibition of UL97 protein kinase. Methods In this phase 3, open-label study, hematopoietic-cell and solid-organ transplant recipients with R/R cytomegalovirus were randomized 2:1 to maribavir 400mg BID or investigator-assigned therapy (IAT; valganciclovir/ganciclovir, foscarnet, or cidofovir) for 8 weeks, with 12 weeks follow-up. Primary endpoint was confirmed cytomegalovirus clearance at end of Week 8. Key secondary endpoint was achievement of cytomegalovirus clearance and symptom control at end of Week 8, maintained through Week 16. Results 352 patients were randomized (235 maribavir; 117 IAT). Significantly more patients in the maribavir versus IAT group achieved the primary endpoint (55.7% vs 23.9%; adjusted difference [95% CI]: 32.8% [22.80–42.74]; P<.001) and key secondary endpoint (18.7% vs 10.3%; adjusted difference [95% CI]: 9.5% [2.02–16.88]; P=.01). Rates of treatment-emergent adverse events (TEAEs) were similar between groups (maribavir, 97.4%; IAT, 91.4%). Maribavir was associated with less acute kidney injury versus foscarnet (8.5% vs 21.3%) and neutropenia versus valganciclovir/ganciclovir (9.4% vs 33.9%). Fewer patients discontinued treatment due to TEAEs with maribavir (13.2%) than IAT (31.9%). One patient per group had fatal treatment-related TEAEs. Conclusions Maribavir was superior to IAT for cytomegalovirus viremia clearance, and viremia clearance plus symptom control maintained post-therapy in transplant recipients with R/R cytomegalovirus. Maribavir had fewer treatment discontinuations due to TEAEs than IAT.

In this multicenter, dose-ranging study of maribavir for the treatment of cytomegalovirus (CMV) infections deemed refractory or resistant to current antivirals, 67% of patients achieved clearance of CMV viremia within 6 weeks, with responses maintained for up to 24 weeks.

ObjectivePterygium is considered to be a proliferative overgrowth of bulbar conjunctiva that can induce significant astigmatism and cause visual impairment; this is the first meta-analysis to investigate the pooled prevalence and risk factors for pterygium in the global world.DesignA systematic review and meta-analysis of population-based studies.SettingInternational.ParticipantsA total of 20 studies with 900 545 samples were included.Primary outcome measureThe pooled prevalence and risk factors for pterygium.Results20 studies were included. The pooled prevalence of pterygium was 10.2% (95% CI 6.3% to 16.1%). The pooled prevalence among men was higher than that among women (14.5% vs 13.6%). The proportion of participants with unilateral cases of pterygium was higher than that of participants with bilateral cases of pterygium. We found a trend that the higher pooled prevalence of pterygium was associated with increasing geographical latitude and age in the world. The pooled OR was 2.32 (95% CI 1.66 to 3.23) for the male gender and 1.76 (95% CI 1.55 to 2.00) for outdoor activity, respectively.ConclusionsThe pooled prevalence of pterygium was relatively high, especially for low latitude regions and the elderly. There were many modifiable risk factors associated with pterygium to which healthcare providers should pay more attention.