Why did maribavir fail in stem-cell transplants?

摘要

In this issue of The Lancet Infectious Diseases, Francisco Marty and colleagues1 report a very important but negative study. The study was a multicentre, multinational, randomised, placebo-controlled, double-blind, phase 3 trial to establish the efficacy of maribavir in prevention of cytomegalovirus infection and disease in recipients of stem-cell transplantation. The trial failed to show superiority of prophylaxis with maribavir compared with placebo (with subsequent pre-emptive therapy with valganciclovir or ganciclovir once cytomegalovirus viraemia was detected). Frequency of cytomegalovirus disease was almost identical in the maribavir (44%) and placebo (pre-emptive; 4'8%) groups. Viral detection by PCR showed similar results for both groups too.