Letermovir-Based Cytomegalovirus Prophylaxis with Tacrolimus and Everolimus Immunosuppression: Real-World Pharmacokinetic Interaction, Safety, and Viral Suppression (ATC 2026) - Jun 17, 2026 - Abstract #Abstract B369; Pres time: Jun 21, 2026; 02:45 PM - 03:45 PM; Location: Exhibit Hall; "*Purpose: Letermovir has demonstrated non-inferiority to valganciclovir for 200-day prophylaxis in cytomegalovirus (CMV) D⁺/R⁻ kidney transplant recipients, and its safety in both CMV D⁺/R⁻ and R⁺ recipients has been validated in global and Japanese phase III trials. Letermovir substantially increased tacrolimus and everolimus exposure, necessitating prompt dose reductions at initiation and reciprocal dose escalations after discontinuation, confirming a clinically significant yet predictable CYP3A-mediated interaction. With protocol-driven intensive therapeutic drug monitoring, these fluctuations were effectively managed without graft dysfunction or unexpected toxicity. This study demonstrated that letermovir prophylaxis, in combination with everolimus-based reduced tacrolimus therapy, was safe and effective throughout the prophylaxis period."
Clinical • PK/PD data • Real-world • Real-world evidence • Cytomegalovirus Infection • Infectious Disease
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J. Uchida; N. Shunji; Y. Machida; T. Iwai; T. Naganuma; M. Kato; T. Yamasaki; T. Otoshi; K. Kuratsukuri
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