Decreased incidence of cytomegalovirus infection with sirolimus in a post hoc randomized, multicenter study in lung transplantation

Bijan Ghassemieh, Vivek N. Ahya, Maher A. Baz, Vincent G. Valentine, Selim M. Arcasoy, Robert B. Love, Harish Seethamraju, Charles G. Alex, Remzi Bag, Nilto C. Deoliveira, Wickii T. Vigneswaran, Jeff Charbeneau, Edward R. Garrity, Sangeeta M. Bhorade

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Cytomegalovirus (CMV) is the most common opportunistic infection in lung transplantation. A recent multicenter, randomized trial (the AIRSAC study) comparing sirolimus to azathioprine in lung transplant recipients showed a decreased incidence of CMV events in the sirolimus cohort. To better characterize this relationship of decreased incidence of CMV events with sirolimus, we examined known risk factors and characteristics of CMV events from the AIRSAC database. Methods: The AIRSAC database included 181 lung transplant patients from 8 U.S.-based lung transplant centers that were randomized to sirolimus or azathioprine at 3 months post-transplantation. CMV incidence, prophylaxis, diagnosis and treatment data were all prospectively collected. Prophylaxis and treatment of CMV were at the discretion of each institution. Results: The overall incidence of any CMV event was decreased in the sirolimus arm when compared with the azathioprine arm at 1 year after lung transplantation (relative risk [RR] = 0.67, confidence interval [CI] 0.55 to 0.82, p < 0.01). This decreased incidence of CMV events with sirolimus remained significant after adjusting for confounding factors of CMV serostatus and CMV prophylaxis. Conclusions: These data support results from other solid-organ transplantation studies and suggest further investigation of this agent in the treatment of lung transplant recipients at high risk for CMV events.

Original languageEnglish (US)
Pages (from-to)701-706
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume32
Issue number7
DOIs
StatePublished - Jul 2013

Fingerprint

Lung Transplantation
Cytomegalovirus Infections
Sirolimus
Cytomegalovirus
Multicenter Studies
Incidence
Azathioprine
Lung
Arm
Databases
Transplants
Opportunistic Infections
Organ Transplantation
Therapeutics
Transplantation
Confidence Intervals

Keywords

  • azathioprine
  • cytomegalovirus
  • lung transplantation
  • sirolimus

ASJC Scopus subject areas

  • Transplantation
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Decreased incidence of cytomegalovirus infection with sirolimus in a post hoc randomized, multicenter study in lung transplantation. / Ghassemieh, Bijan; Ahya, Vivek N.; Baz, Maher A.; Valentine, Vincent G.; Arcasoy, Selim M.; Love, Robert B.; Seethamraju, Harish; Alex, Charles G.; Bag, Remzi; Deoliveira, Nilto C.; Vigneswaran, Wickii T.; Charbeneau, Jeff; Garrity, Edward R.; Bhorade, Sangeeta M.

In: Journal of Heart and Lung Transplantation, Vol. 32, No. 7, 07.2013, p. 701-706.

Research output: Contribution to journalArticle

Ghassemieh, B, Ahya, VN, Baz, MA, Valentine, VG, Arcasoy, SM, Love, RB, Seethamraju, H, Alex, CG, Bag, R, Deoliveira, NC, Vigneswaran, WT, Charbeneau, J, Garrity, ER & Bhorade, SM 2013, 'Decreased incidence of cytomegalovirus infection with sirolimus in a post hoc randomized, multicenter study in lung transplantation', Journal of Heart and Lung Transplantation, vol. 32, no. 7, pp. 701-706. https://doi.org/10.1016/j.healun.2013.04.010
Ghassemieh, Bijan ; Ahya, Vivek N. ; Baz, Maher A. ; Valentine, Vincent G. ; Arcasoy, Selim M. ; Love, Robert B. ; Seethamraju, Harish ; Alex, Charles G. ; Bag, Remzi ; Deoliveira, Nilto C. ; Vigneswaran, Wickii T. ; Charbeneau, Jeff ; Garrity, Edward R. ; Bhorade, Sangeeta M. / Decreased incidence of cytomegalovirus infection with sirolimus in a post hoc randomized, multicenter study in lung transplantation. In: Journal of Heart and Lung Transplantation. 2013 ; Vol. 32, No. 7. pp. 701-706.
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abstract = "Background: Cytomegalovirus (CMV) is the most common opportunistic infection in lung transplantation. A recent multicenter, randomized trial (the AIRSAC study) comparing sirolimus to azathioprine in lung transplant recipients showed a decreased incidence of CMV events in the sirolimus cohort. To better characterize this relationship of decreased incidence of CMV events with sirolimus, we examined known risk factors and characteristics of CMV events from the AIRSAC database. Methods: The AIRSAC database included 181 lung transplant patients from 8 U.S.-based lung transplant centers that were randomized to sirolimus or azathioprine at 3 months post-transplantation. CMV incidence, prophylaxis, diagnosis and treatment data were all prospectively collected. Prophylaxis and treatment of CMV were at the discretion of each institution. Results: The overall incidence of any CMV event was decreased in the sirolimus arm when compared with the azathioprine arm at 1 year after lung transplantation (relative risk [RR] = 0.67, confidence interval [CI] 0.55 to 0.82, p < 0.01). This decreased incidence of CMV events with sirolimus remained significant after adjusting for confounding factors of CMV serostatus and CMV prophylaxis. Conclusions: These data support results from other solid-organ transplantation studies and suggest further investigation of this agent in the treatment of lung transplant recipients at high risk for CMV events.",
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AU - Ghassemieh, Bijan

AU - Ahya, Vivek N.

AU - Baz, Maher A.

AU - Valentine, Vincent G.

AU - Arcasoy, Selim M.

AU - Love, Robert B.

AU - Seethamraju, Harish

AU - Alex, Charles G.

AU - Bag, Remzi

AU - Deoliveira, Nilto C.

AU - Vigneswaran, Wickii T.

AU - Charbeneau, Jeff

AU - Garrity, Edward R.

AU - Bhorade, Sangeeta M.

PY - 2013/7

Y1 - 2013/7

N2 - Background: Cytomegalovirus (CMV) is the most common opportunistic infection in lung transplantation. A recent multicenter, randomized trial (the AIRSAC study) comparing sirolimus to azathioprine in lung transplant recipients showed a decreased incidence of CMV events in the sirolimus cohort. To better characterize this relationship of decreased incidence of CMV events with sirolimus, we examined known risk factors and characteristics of CMV events from the AIRSAC database. Methods: The AIRSAC database included 181 lung transplant patients from 8 U.S.-based lung transplant centers that were randomized to sirolimus or azathioprine at 3 months post-transplantation. CMV incidence, prophylaxis, diagnosis and treatment data were all prospectively collected. Prophylaxis and treatment of CMV were at the discretion of each institution. Results: The overall incidence of any CMV event was decreased in the sirolimus arm when compared with the azathioprine arm at 1 year after lung transplantation (relative risk [RR] = 0.67, confidence interval [CI] 0.55 to 0.82, p < 0.01). This decreased incidence of CMV events with sirolimus remained significant after adjusting for confounding factors of CMV serostatus and CMV prophylaxis. Conclusions: These data support results from other solid-organ transplantation studies and suggest further investigation of this agent in the treatment of lung transplant recipients at high risk for CMV events.

AB - Background: Cytomegalovirus (CMV) is the most common opportunistic infection in lung transplantation. A recent multicenter, randomized trial (the AIRSAC study) comparing sirolimus to azathioprine in lung transplant recipients showed a decreased incidence of CMV events in the sirolimus cohort. To better characterize this relationship of decreased incidence of CMV events with sirolimus, we examined known risk factors and characteristics of CMV events from the AIRSAC database. Methods: The AIRSAC database included 181 lung transplant patients from 8 U.S.-based lung transplant centers that were randomized to sirolimus or azathioprine at 3 months post-transplantation. CMV incidence, prophylaxis, diagnosis and treatment data were all prospectively collected. Prophylaxis and treatment of CMV were at the discretion of each institution. Results: The overall incidence of any CMV event was decreased in the sirolimus arm when compared with the azathioprine arm at 1 year after lung transplantation (relative risk [RR] = 0.67, confidence interval [CI] 0.55 to 0.82, p < 0.01). This decreased incidence of CMV events with sirolimus remained significant after adjusting for confounding factors of CMV serostatus and CMV prophylaxis. Conclusions: These data support results from other solid-organ transplantation studies and suggest further investigation of this agent in the treatment of lung transplant recipients at high risk for CMV events.

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