A Phase 3 interventional study of Letermovir and Placebo in Prevention of CMV Infection or Disease, sponsored by Merck Sharp & Dohme LLC. Completed. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-09-11.
Sponsored by Merck Sharp & Dohme LLC · Phase 3, Interventional, and Prevention
The study evaluated the efficacy and safety of letermovir (MK-8228) for the prevention of clinically-significant CMV infection in adult, CMV-seropositive recipients of allogeneic hematopoietic stem cell transplant (HSCT). The hypothesis being tested was that MK-8228 is superior to placebo in the prevention of clinically-significant CMV infection through Week 24 post-transplant.
6,687 studies on the registry are indexed under Infections; 807 are open to participants now.
This study's enrollment of 570 is above the median of 120 across 4,200 interventional studies indexed under Infections.
Browse Infections studies →Merck Sharp & Dohme LLC is the lead sponsor of 2,114 studies on the registry; 133 are open to participants now.
Of its 489 completed or terminated interventional studies of FDA-regulated products, 362 (74%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Letermovir oral or intravenous (IV) formulation was administered once daily for up to 14 weeks, beginning up to Day 28 days post-transplant. The dose was 240 mg once daily for participants receiving concomitant cyclosporin A and 480 mg once daily for participants not receiving cyclosporin A. Intravenous infusion was administered only to participants who are unable to swallow tablets or who have a condition that may interfere with absorption of the tablets.
Drug: Letermovir
Placebo oral or IV formulation was administered once daily for up to 14 weeks, beginning up to Day 28 post-transplant. The number of placebo tablets was to mimic that for letermovir administration according to the concomitant cyclosporin A status. Intravenous infusion was administered only to participants who are unable to swallow tablets or who have a condition that may interfere with absorption of the tablets.
Drug: Placebo
Letermovir 240 mg / 480 mg tablets, or 240 mg / 480 mg intravenous solution in 250 mL to be infused over 60 minutes.
Also known as: MK-8228
Placebo tablets, or intravenous solution in 250 mL to be infused over 60 minutes.
Percentage of Participants With Clinically-significant CMV Infection up to Week 24 Post-transplant
Clinically-significant CMV infection was defined as either one of the following: 1) onset of CMV end-organ disease, or 2) initiation of anti-CMV pre-emptive therapy based on documented CMV viremia and the clinical condition of the participant. The percentage of participants with clinically-significant CMV infection was assessed.
Time frame: Up to Week 24 post-transplant
Time to Onset of Clinically-significant CMV Infection (Kaplan-Meier Estimate of Percentage of Participants With a Qualifying Event at Week 24 Post-transplant)
Clinically-significant CMV infection was defined as either one of the following: 1) onset of CMV end-organ disease, or 2) initiation of anti-CMV pre-emptive therapy based on documented CMV viremia and the clinical condition of the participant. Time to onset of clinically-significant CMV infection was defined from the day of transplantation to the day the participant developed clinically-significant CMV infection, and was analyzed by the Kaplan-Meier method. Participants were censored at the last assessment for participants who discontinued or did not develop clinically-significant CMV infection.
Time frame: Up to Week 24 post-transplant
Percentage of Participants With Clinically-significant CMV Infection up to Week 14 Post-transplant
Clinically-significant CMV infection was defined as either one of the following: 1) onset of CMV end-organ disease, or 2) initiation of anti-CMV pre-emptive therapy based on documented CMV viremia and the clinical condition of the participant. The percentage of participants with clinically-significant CMV infection was assessed.
Time frame: Up to Week 14 post-transplant
Percentage of Participants With CMV End-organ Disease up to Week 24 Post-transplant
CMV end-organ disease met per-protocol diagnostic criteria for CMV-pneumonia, gastrointestinal disease, hepatitis, central nervous system disease, retinitis, nephritis, cystitis, myocarditis, pancreatitis, or other disease categories. Only Clinical Adjudication Committee-confirmed CMV end-organ disease was included in this analysis. The percentage of participants with CMV end-organ disease was assessed.
Time frame: Up to Week 24 post-transplant
Percentage of Participants With CMV End-organ Disease up to Week 14 Post-transplant
CMV end-organ disease met per-protocol diagnostic criteria for CMV-pneumonia, gastrointestinal disease, hepatitis, central nervous system disease, retinitis, nephritis, cystitis, myocarditis, pancreatitis, or other disease categories. Only Clinical Adjudication Committee-confirmed CMV end-organ disease was included in this analysis. The percentage of participants with CMV end-organ disease was assessed.
Time frame: Up to Week 14 post-transplant
Percentage of Participants With Pre-emptive Therapy for CMV Viremia up to Week 14 Post-transplant
Initiation of anti-CMV pre-emptive therapy was based on documented CMV viremia and the clinical condition of the participant. The percentage of participants with initiation of anti-CMV pre-emptive anti-CMV therapy was assessed.
Time frame: Up to Week 14 post-transplant
Percentage of Participants With Pre-emptive Therapy for CMV Viremia up to Week 24 Post-transplant
Initiation of anti-CMV pre-emptive therapy was based on documented CMV viremia and the clinical condition of the participant. The percentage of participants with initiation of anti-CMV pre-emptive anti-CMV therapy was assessed.
Time frame: Up to Week 24 post-transplant
Time to Initiation of Pre-emptive Therapy for CMV Viremia (Kaplan-Meier Estimate of Percentage of Participants With a Qualifying Event at Week 24 Post-transplant)
The need for anti-CMV pre-emptive therapy was based on documented CMV viremia and the clinical condition of the participant. The outcome was calculated from the day of transplantation to the start of anti-CMV pre-emptive therapy, and was analyzed by the Kaplan-Meier method. Participants were censored at the last assessment for participants who discontinued or did not initiate pre-emptive therapy.
Time frame: Up to Week 24 post-transplant
Percentage of Participants With One or More Adverse Events up to Week 48 Post-transplant
An adverse event is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An adverse event can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event.
Time frame: Up to Week 48 post-transplant
Percentage of Participants Discontinued From Study Medication Due to an Adverse Event
An adverse event is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An adverse event can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event.
Time frame: Up to Week 14 post-transplant
A total of 738 participants were screened, 570 were randomized 2:1 letermovir:placebo, and 565 received at least one dose of study medication.
| Milestone | Letermovir | Placebo |
|---|---|---|
| Started | 376 | 194 |
| Treated participants | 373 | 192 |
| Completed | 244 | 119 |
| Not completed | 132 | 75 |
| Withdrew: Adverse event | 6 | 3 |
| Withdrew: Death | 71 | 44 |
| Withdrew: Lost to follow-up | 8 | 4 |
| Withdrew: Physician decision | 15 | 5 |
| Withdrew: Withdrawal by subject | 28 | 17 |
| Withdrew: Non-compliance with study drug | 1 | 0 |
| Withdrew: Not treated | 3 | 2 |
Clinically-significant CMV infection was defined as either one of the following: 1) onset of CMV end-organ disease, or 2) initiation of anti-CMV pre-emptive therapy based on documented CMV viremia and the clinical condition of the participant. The percentage of participants with clinically-significant CMV infection was assessed.
| Percentage of participants | Letermovir | Placebo |
|---|---|---|
| Percentage of Participants With Clinically-significant CMV Infection up to Week 24 Post-transplant | 37.5 | 60.6 |
Clinically-significant CMV infection was defined as either one of the following: 1) onset of CMV end-organ disease, or 2) initiation of anti-CMV pre-emptive therapy based on documented CMV viremia and the clinical condition of the participant. Time to onset of clinically-significant CMV infection was defined from the day of transplantation to the day the participant developed clinically-significant CMV infection, and was analyzed by the Kaplan-Meier method. Participants were censored at the last assessment for participants who discontinued or did not develop clinically-significant CMV infection.
| Percentage of participants | Letermovir | Placebo |
|---|---|---|
| Time to Onset of Clinically-significant CMV Infection (Kaplan-Meier Estimate of Percentage of Participants With a Qualifying Event at Week 24 Post-transplant) | 18.9 (14.4 to 23.5) | 44.3 (36.4 to 52.1) |
Clinically-significant CMV infection was defined as either one of the following: 1) onset of CMV end-organ disease, or 2) initiation of anti-CMV pre-emptive therapy based on documented CMV viremia and the clinical condition of the participant. The percentage of participants with clinically-significant CMV infection was assessed.
| Percentage of participants | Letermovir | Placebo |
|---|---|---|
| Percentage of Participants With Clinically-significant CMV Infection up to Week 14 Post-transplant | 19.1 | 50.0 |
CMV end-organ disease met per-protocol diagnostic criteria for CMV-pneumonia, gastrointestinal disease, hepatitis, central nervous system disease, retinitis, nephritis, cystitis, myocarditis, pancreatitis, or other disease categories. Only Clinical Adjudication Committee-confirmed CMV end-organ disease was included in this analysis. The percentage of participants with CMV end-organ disease was assessed.
| Percentage of participants | Letermovir | Placebo |
|---|---|---|
| Percentage of Participants With CMV End-organ Disease up to Week 24 Post-transplant | 2.0 | 2.4 |
CMV end-organ disease met per-protocol diagnostic criteria for CMV-pneumonia, gastrointestinal disease, hepatitis, central nervous system disease, retinitis, nephritis, cystitis, myocarditis, pancreatitis, or other disease categories. Only Clinical Adjudication Committee-confirmed CMV end-organ disease was included in this analysis. The percentage of participants with CMV end-organ disease was assessed.
| Percentage of participants | Letermovir | Placebo |
|---|---|---|
| Percentage of Participants With CMV End-organ Disease up to Week 14 Post-transplant | 0.4 | 1.4 |
Initiation of anti-CMV pre-emptive therapy was based on documented CMV viremia and the clinical condition of the participant. The percentage of participants with initiation of anti-CMV pre-emptive anti-CMV therapy was assessed.
| Percentage of participants | Letermovir | Placebo |
|---|---|---|
| Percentage of Participants With Pre-emptive Therapy for CMV Viremia up to Week 14 Post-transplant | 18.8 | 49.4 |
Initiation of anti-CMV pre-emptive therapy was based on documented CMV viremia and the clinical condition of the participant. The percentage of participants with initiation of anti-CMV pre-emptive anti-CMV therapy was assessed.
| Percentage of participants | Letermovir | Placebo |
|---|---|---|
| Percentage of Participants With Pre-emptive Therapy for CMV Viremia up to Week 24 Post-transplant | 36.6 | 59.4 |
The need for anti-CMV pre-emptive therapy was based on documented CMV viremia and the clinical condition of the participant. The outcome was calculated from the day of transplantation to the start of anti-CMV pre-emptive therapy, and was analyzed by the Kaplan-Meier method. Participants were censored at the last assessment for participants who discontinued or did not initiate pre-emptive therapy.
| Percentage of participants | Letermovir | Placebo |
|---|---|---|
| Time to Initiation of Pre-emptive Therapy for CMV Viremia (Kaplan-Meier Estimate of Percentage of Participants With a Qualifying Event at Week 24 Post-transplant) | 17.2 (12.8 to 21.6) | 42.4 (34.7 to 50.2) |
An adverse event is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An adverse event can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event.
| Percentage of participants | Letermovir | Placebo |
|---|---|---|
| Percentage of Participants With One or More Adverse Events up to Week 48 Post-transplant | 98.4 | 100.0 |
An adverse event is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An adverse event can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event.
| Percentage of participants | Letermovir | Placebo |
|---|---|---|
| Percentage of Participants Discontinued From Study Medication Due to an Adverse Event | 19.6 | 51.6 |
Collected over Up to Week 48 post-transplant. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Letermovir | — | 202/373 (54.2%) | 360/373 (96.5%) |
| Placebo | — | 115/192 (59.9%) | 186/192 (96.9%) |
| Event | Letermovir | Placebo |
|---|---|---|
| Graft versus host diseaseImmune system disorders | 45/373 | 29/192 |
| Acute myeloid leukaemia recurrentNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 23/373 | 17/192 |
| Cytomegalovirus infectionInfections and infestations | 14/373 | 15/192 |
| Acute kidney injuryRenal and urinary disorders | 7/373 | 9/192 |
| PneumoniaInfections and infestations | 15/373 | 6/192 |
| Septic shockInfections and infestations | 5/373 | 7/192 |
| PyrexiaGeneral disorders | 10/373 | 4/192 |
| DiarrhoeaGastrointestinal disorders | 3/373 | 5/192 |
| SepsisInfections and infestations | 8/373 | 4/192 |
| Multiple organ dysfunction syndromeGeneral disorders | 2/373 | 4/192 |
| Event | Letermovir | Placebo |
|---|---|---|
| Cytomegalovirus infectionInfections and infestations | 55/373 | 77/192 |
| Graft versus host diseaseImmune system disorders | 147/373 | 74/192 |
| DiarrhoeaGastrointestinal disorders | 108/373 | 51/192 |
| NauseaGastrointestinal disorders | 106/373 | 53/192 |
| RashSkin and subcutaneous tissue disorders | 90/373 | 51/192 |
| PyrexiaGeneral disorders | 85/373 | 50/192 |
| VomitingGastrointestinal disorders | 79/373 | 35/192 |
| CoughRespiratory, thoracic and mediastinal disorders | 62/373 | 27/192 |
| Oedema peripheralGeneral disorders | 60/373 | 23/192 |
| HeadacheNervous system disorders | 58/373 | 24/192 |
Randomized participants
| Age, Continuous(Years) | Letermovir | Placebo | Total |
|---|---|---|---|
| Mean | 50.8 ± 13.4 | 50.8 ± 14.8 | 50.8 ± 13.9 |
| Sex: Female, Male(Participants) | Letermovir | Placebo | Total |
|---|---|---|---|
| Female | 162 | 77 | 239 |
| Male | 214 | 117 | 331 |
| Risk Stratum for CMV Reactivation(Participants) | Letermovir | Placebo | Total |
|---|---|---|---|
| High risk | 122 | 54 | 176 |
| Low risk | 254 | 140 | 394 |
No study locations are listed for this record.
Plan to share: Yes — http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
This study is completed, as verified in Aug 2019. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Merck Sharp & Dohme LLC