Pharmacokinetics of Valganciclovir and Ganciclovir Following Multiple Oral Dosages of Valganciclovir in HIV- and CMV-Seropositive Volunteers

Brown, Frances C.; Banken, Ludger; Saywell, K. L.; Arum, Inger

doi:10.2165/00003088-199937020-00005

Cited by 144 publications

(78 citation statements)

References 10 publications

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“…The AUC 24 values of GCV following dosing with VGC in this study (21.1 and 41.7 g ⅐ h/ml for the 450-and 900-mg doses, respectively) were higher than the AUC 24 values of 12.7 and 24.8 g ⅐ h/ml observed in HIV-infected individuals receiving doses of 450 and 875 mg, respectively (1,12). Evaluation of the pharmacokinetic parameters suggests that the difference is due to the longer terminal elimination t 1/2 (5.1 to 5.22 h) seen in the transplant recipients compared to that in HIV-infected patients (3.66 h).…”

Section: Discussioncontrasting

confidence: 70%

Valganciclovir Results in Improved Oral Absorption of Ganciclovir in Liver Transplant Recipients

Pescovitz

Rabkin

Merion

et al. 2000

Antimicrob Agents Chemother

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238

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Section: Discussioncontrasting

confidence: 70%

Valganciclovir Results in Improved Oral Absorption of Ganciclovir in Liver Transplant Recipients

Pescovitz

Rabkin

Merion

et al. 2000

Antimicrob Agents Chemother

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329

238

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“…A drawback for ganciclovir is its low oral bioavailability, making intravenous administration necessary for most indications. Recently, the valyl ester valganciclovir (Valcyte) has become available as an oral prodrug, offering a ganciclovir exposure comparable to the intravenous formulation (45). It is currently indicated for the prevention of HCMV disease in certain subsets of transplant recipients.…”

Section: Ganciclovir and Acyclovirmentioning

confidence: 99%

Update on Human Herpesvirus 6 Biology, Clinical Features, and Therapy

2005

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Human herpesvirus 6 (HHV-6) is a betaherpesvirus that is closely related to human cytomegalovirus. It was discovered in 1986, and HHV-6 literature has expanded considerably in the past 10 years. We here present an up-to-date and complete overview of the recent developments concerning HHV-6 biological features, clinical associations, and therapeutic approaches. HHV-6 gene expression regulation and gene products have been systematically characterized, and the multiple interactions between HHV-6 and the host immune system have been explored. Moreover, the discovery of the cellular receptor for HHV-6, CD46, has shed a new light on HHV-6 cell tropism. Furthermore, the in vitro interactions between HHV-6 and other viruses, particularly human immunodeficiency virus, and their relevance for the in vivo situation are discussed, as well as the transactivating capacities of several HHV-6 proteins. The insight into the clinical spectrum of HHV-6 is still evolving and, apart from being recognized as a major pathogen in transplant recipients (as exemplified by the rising number of prospective clinical studies), its role in central nervous system disease has become increasingly apparent. Finally, we present an overview of therapeutic options for HHV-6 therapy (including modes of action and resistance mechanisms)

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“…Previous pharmacokinetic studies showed similar drug exposure to ganciclovir after a single oral dose of 900 mg valganciclovir as compared to an intravenous dose of 5 mg/kg ganciclovir. [9][10][11] Recently, oral valganciclovir and intravenous ganciclovir were shown to have similar efficacy in pre-emptive CMV treatment in solid organ transplant recipients. [12][13][14] As a consequence, the prevention of CMV disease in high-risk renal, renal-pancreas and heart transplant patients was added as another indication to the original approval of valganciclovir for the treatment of CMV retinitis in AIDS patients.…”

Section: Introductionmentioning

confidence: 99%

Oral valganciclovir as pre-emptive therapy has similar efficacy on cytomegalovirus DNA load reduction as intravenous ganciclovir in allogeneic stem cell transplantation recipients

Heiden

Kalpoe

Barge

et al. 2006

Bone Marrow Transplant

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The efficacy and safety of oral valganciclovir was compared to ganciclovir i.v. in pre-emptive treatment of cytomegalovirus (CMV) in T-cell-depleted allogeneic stem cell transplant (allo-SCT) recipients. A therapeutic guideline was developed to allow the safe application of valganciclovir in allo-SCT recipients requiring CMV therapy. In total, 107 consecutive transplant recipients were evaluated. Cytomegalovirus DNA load in plasma was monitored longitudinally; details on antiviral therapy and treatment responses were analyzed retrospectively. Fifty-seven CMV treatment episodes were recorded in 34 patients: 20 with valganciclovir (900 mg twice-daily) and 37 with ganciclovir (5 mg/kg twice-daily). Median CMV DNA load reduction was 0.079 and 0.069 log 10 copies/ml/ day in the ganciclovir and valganciclovir group, respectively. Good response on CMV DNA load (reduction below 3.0 log 10 copies/ml) was observed in 75.7% of ganciclovir and 80.0% of valganciclovir treatment episodes. Severe adverse effects were not observed and CMV-related disease did not occur. However, the percentage of patients receiving erythrocyte transfusion was higher in the group of patients receiving ganciclovir as compared to valganciclovir (41 versus 20%, P ¼ 0.116). In conclusion, pre-emptive treatment with valganciclovir and ganciclovir, led to similar reduction of CMV DNA load. Oral valganciclovir is an attractive and safe alternative for pre-emptive CMV treatment in T-cell-depleted allo-SCT recipients.

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Pharmacokinetics of Valganciclovir and Ganciclovir Following Multiple Oral Dosages of Valganciclovir in HIV- and CMV-Seropositive Volunteers

Cited by 144 publications

References 10 publications

Valganciclovir Results in Improved Oral Absorption of Ganciclovir in Liver Transplant Recipients

Valganciclovir Results in Improved Oral Absorption of Ganciclovir in Liver Transplant Recipients

Update on Human Herpesvirus 6 Biology, Clinical Features, and Therapy

Oral valganciclovir as pre-emptive therapy has similar efficacy on cytomegalovirus DNA load reduction as intravenous ganciclovir in allogeneic stem cell transplantation recipients

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