Increased osteoprotegerin predicts poor virological outcome during anticytomegalovirus therapy in solid organ transplant recipients
Ueland T, Rollag, H et alTransplantation 2015; 99(1):100-5.
Aims
The VICTOR Study compared oral valganciclovir and intravenous ganciclovir for the treatment of CMV disease in solid organ transplant recipients. This post hoc analysis was performed to investigate whether circulating levels of osteoprotegerin are related to features of CMV disease and treatment outcomes during CMV
Interventions
The VICTOR study compared oral valganciclovir and intravenous ganciclovir
Participants
291 patients from the VICTOR study who were CMV DNAemia positive
Outcomes
Plasma osteoprotegerin levels
Follow-up
49 days
CET Conclusions
This manuscript reports a post-hoc analysis of the VICTOR study, in which compared oral valganciclovir to IV ganciclovir in the treatment of CMV following solid organ transplantation. This analysis focusses on the levels of osteoprotegerin (a marker of vascular and systemic inflammation) in patients with CMV DNA-aemia. Elevated plasma osteoprotegerin levels were found to be associated with tissue invasive disease, higher baseline viral load and poor response to antiviral treatment. This is a post-hoc analysis in a low risk population, but these results certainly support further study to determine the role of osteoprotegerin as a prognostic marker (and the potential for intervention) in recipients with CMV infection.
Data analysis
Per protocol analysis
Quality notes
Previously reported: Asberg, A., A. Humar, et al. (2007). "Oral Valganciclovir Is Noninferior to Intravenous Ganciclovir for the Treatment of Cytomegalovirus Disease in Solid Organ Transplant Recipients." American Journal of Transplantation 7(9): 2106-2113.
Trial registration
NCT00431353