CMV DiseasePhase 3NCT03443869
Letermovir Versus Valganciclovir to Prevent Human Cytomegalovirus Disease in Kidney Transplant Recipients (MK-8228-002)
A Phase 3 study testing Letermovir, Valganciclovir and Acyclovir (ACV) in people with CMV Disease, run by Merck Sharp & Dohme LLC at 94 sites in 16 countries.
Trial summary
The primary objective of this study is to evaluate the efficacy of letermovir (LET) versus valganciclovir (VGCV) in preventing CMV disease in adult kidney transplant recipients. The primary hypotheses are that LET is non-inferior to VGCV; and if non-inferiority is demonstrated, that LET is superior to VGCV, in… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- CMV Disease
- What is being tested?
- Letermovir, Valganciclovir and Acyclovir (ACV)
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 601 participants
- Where
- 94 sitesin 16 countries
- Study dates
- 3 May 2018to 5 Apr 2022
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Have a documented negative serostatus for CMV within 180 days prior to randomization.
- Anticipate receiving a primary or secondary allograft kidney from a CMV IgG seropositive (D+) donor at the time of screening AND have received a primary or secondary allograft kidney from a documented D+ donor at the time of randomization.
- Be within 0 (i.e. day of transplantation) to 7 days (inclusive) post-kidney transplant at the time of randomization.
- Males agree to use contraception during the treatment period, and for at least 90 days after the last dose of study treatment, and refrain from donating sperm during this period.
- Female is not pregnant, not breastfeeding, and is not a woman of childbearing potential (WOCBP), OR if a WOCBP, agrees to follow the contraception guidance during the treatment period and for at least 90 days after the last dose of study treatment.
Who cannot join
- Has received a previous solid organ transplant or hematopoietic stem cell transplant (HSCT). Note: Participants who have received a prior primary allograft kidney may be enrolled, provided that all other inclusion/exclusion criteria are met.
- Is a multi-organ transplant recipient (e.g. kidney-pancreas). Double kidney transplant recipients (i.e. transplant of two kidneys from the same donor to the same recipient simultaneously) will be excluded.
- Has a history of CMV disease or suspected CMV disease within 6 months prior to randomization.
- Has suspected or known hypersensitivity to active or inactive ingredients of LET formulations, VGCV, GCV, and/or ACV formulations.
- Is on dialysis or plasmapheresis at the time of randomization. Dialysis includes hemofiltration.
- Has Child-Pugh Class C severe hepatic insufficiency at screening.
Show all 19Show fewer
- Has both moderate hepatic insufficiency AND moderate-to-severe renal insufficiency at screening.
- Has any uncontrolled infection on the day of randomization.
- Has documented positive results for human immunodeficiency virus antibody (HIV-Ab) test at any time prior to randomization, or for hepatitis C virus antibody (HCV-Ab) and with detectable HCV ribonucleic acid (RNA) within 90 days prior to randomization, or hepatitis B surface antigen (HBsAg) within 90 days prior to randomization.
- Requires mechanical ventilation, or is hemodynamically unstable, at the time of randomization.
- Has a history of malignancy ≤5 years prior to signing informed consent.
- Is pregnant or expecting to conceive, is breastfeeding, or plans to breastfeed from the time of consent through at least 90 days following cessation of study therapy.
- Is expecting to donate eggs or sperm starting from the time of consent through at least 90 days following cessation of study therapy.
- Has received within 30 days prior to randomization or plans to receive during the study any of the following anti-CMV IgG antibody treatment or anti-CMV drug therapy including the following: Cidofovir, CMV hyper-immune globulin, Any investigational CMV antiviral agent/biologic therapy.
- Has received within 7 days prior to randomization or plans to receive during the study any of the following anti-CMV drug therapy: LET, GCV, VGCV, Foscarnet, ACV, Valacyclovir, Famciclovir.
- Is a user of recreational or illicit drugs or has had a recent history (within the last year) of drug or alcohol abuse or dependence.
- Is currently participating or has participated in a study with an unapproved investigational compound or device within 28 days, or 5× half-life of the investigational compound whichever is longer, of initial dosing on this study.
- Has previously participated in this study or any other study involving LET.
- Has previously participated or is currently participating in any study involving administration of a CMV vaccine or another CMV investigational agent, or is planning to participate in a study of a CMV vaccine or another CMV investigational agent during the course of this study.
Trial locations and contacts
94 sites in 16 countries.
94 sites in 16 countries
United States27 sites
The Emory Clinic ( Site 0247)
Atlanta, Georgia, 30322
University of Maryland Medical Center ( Site 0234)
Baltimore, Maryland, 21201
Johns Hopkins Hospital ( Site 0232)
Baltimore, Maryland, 21287
UAB ( Site 0269)
Birmingham, Alabama, 35233
Brigham & Women's Hospital ( Site 0244)
Boston, Massachusetts, 02115
Medical University of South Carolina ( Site 0257)
Charleston, South Carolina, 29425
University of Chicago ( Site 0251)
Chicago, Illinois, 60637
The Ohio State University Wexner Medical Center ( Site 0264)
Columbus, Ohio, 43210
Henry Ford Hospital ( Site 0242)
Detroit, Michigan, 48202
Duke University Medical Center ( Site 0243)
Durham, North Carolina, 27710
Indiana University ( Site 0261)
Indianapolis, Indiana, 46202
Saint Barnabas Medical Center ( Site 0250)
Livingston, New Jersey, 07039
UCLA Medical Center ( Site 0266)
Los Angeles, California, 90095
Vanderbilt University Medical Center ( Site 0275)
Nashville, Tennessee, 37232
Ochsner Clinic Foundation ( Site 0238)
New Orleans, Louisiana, 70121
Icahn School of Medicine at Mount Sinai ( Site 0256)
New York, New York, 10029
Columbia University Medical Center ( Site 0255)
New York, New York, 10032
New York Presbyterian Hospital - Weill Cornell Medical Center ( Site 0276)
New York, New York, 10065
University of Nebraska Medical Center ( Site 0272)
Omaha, Nebraska, 68198
University of Pennsylvania ( Site 0270)
Philadelphia, Pennsylvania, 19104
University of Pittsburgh ( Site 0252)
Pittsburgh, Pennsylvania, 15213
Virginia Commonwealth University ( Site 0245)
Richmond, Virginia, 23298
UC Davis Medical Center ( Site 0271)
Sacramento, California, 95817
University of California-San Francisco ( Site 0236)
San Francisco, California, 94143
University of Washington Medical Center ( Site 0246)
Seattle, Washington, 98195
Stanford Health Care ( Site 0235)
Stanford, California, 94305
Wake Forest University Baptist Medical Center ( Site 0260)
Winston-Salem, North Carolina, 27157
Colombia8 sites
Clinica del Country ( Site 0208)
Bogotá, Bogota D.C., 110221
Clinica Colsanitas S.A. Sede Clinica Universitaria Colombia ( Site 0209)
Bogotá, Bogota D.C., 110311
Hospital Universitario Mayor Mederi CIMED ( Site 0206)
Bogotá, Bogota D.C., 110911
Sociedad de Cirugia de Bogota Hospital de San Jose ( Site 0203)
Bogotá, Bogota D.C., 111411
Fundacion Cardiovascular de Colombia ( Site 0210)
Bucaramanca, Santander Department, 680003
Fundacion Valle del Lili ( Site 0285)
Cali, Valle del Cauca Department, 760032
Centro Medico Imbanaco de Cali S.A ( Site 0201)
Cali, Valle del Cauca Department, 760042
Hospital San Vicente Fundación - Rionegro ( Site 0205)
Rionegro, Antioquia, 054047
France7 sites
CHU de Bordeaux. Hopital Pellegrin ( Site 0055)
Bordeaux, Gironde, 33076
Hopital Henri Mondor du Creteil ( Site 0063)
Créteil, Val-de-Marne, 94000
CHU - Hopital de Bicetre ( Site 0060)
Le Kremlin-Bicêtre, Val-de-Marne, 94270
Hopital Pasteur ( Site 0053)
Nice, Alpes-Maritimes, 51069
Hopital Tenon ( Site 0061)
Paris, 75020
CHU Rangueil ( Site 0054)
Toulouse, Haute-Garonne, 31059
C.H.R.U Bretonneau ( Site 0051)
Tours, Indre-et-Loire, 44093
Argentina6 sites
CEMIC ( Site 0352)
Buenos Aires, Buenos Aires F.D., C1431FWO
Instituto de Nefrologia Nephrology S.A. ( Site 0182)
Buenos Aires, C1425APQ
Hospital Italiano de Buenos Aires ( Site 0188)
CABA, C1199ABD
Instituto de Cardiología de Corrientes Juana F. Cabral ( Site 0181)
Corrientes, W3400AMZ
Hospital El Cruce Nestor Carlos Kirchner ( Site 0351)
San Juan Bautista, Buenos Aires, B1073ABA
Clinica de nefrologia urologia y enfermedades cardiovasculares ( Site 0354)
Santa Fe, S3000BPJ
Australia6 sites
Royal Adelaide Hospital ( Site 0003)
Adelaide, South Australia, 5000
Royal Prince Alfred Hospital ( Site 0005)
Camperdown, New South Wales, 2050
Monash Health-Monash Medical Centre ( Site 0008)
Clayton, Victoria, 3168
Royal Melbourne Hospital ( Site 0007)
Parkville, Victoria, 3050
Westmead Hospital ( Site 0006)
Westmead, New South Wales, 2145
Princess Alexandra Hospital ( Site 0004)
Woolloongabba, Queensland, 4102
Spain6 sites
Hospital del Mar ( Site 0121)
Barcelona, La Coruna, 08003
Hospital Universitari Vall de Hebron ( Site 0112)
Barcelona, 08035
Hospital Clinic i Provincial de Barcelona ( Site 0113)
Barcelona, 08036
Hospital Universitari de Bellvitge IDIBELL ( Site 0114)
L'Hospitalet de Llobregat, La Coruna, 08907
Hospital Doce de Octubre ( Site 0116)
Madrid, 28041
Hospital Universitario Miguel Servet ( Site 0118)
Zaragoza, 50009
Canada5 sites
University of Alberta Hospital ( Site 0221)
Edmonton, Alberta, T6G 2B7
Hopital Maisonneuve-Rosemont CIUSSS de l Est de L Ile de Montreal ( Site 0226)
Montreal, Quebec, H1T 2M4
Toronto General Hospital ( Site 0222)
Toronto, Ontario, M5G 2N2
Vancouver General Hospital ( Site 0224)
Vancouver, British Columbia, V5Z 1M9
St. Paul's Hospital ( Site 0225)
Vancouver, British Columbia, V6Z 1Y6
Mexico5 sites
Centenario Hospital Miguel Hidalgo ( Site 0215)
Aguascalientes, 20259
Instituto Mexicano de Trasplantes S C ( Site 0212)
Cuernavaca, Morelos, 62448
Instituto Nacional de Cardiologia Ignacio Chavez ( Site 0213)
Mexico City, 14080
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran ( Site 0214)
Mexico City, 14080
Faicic S de RL de CV ( Site 0211)
Veracruz, 91900
Poland5 sites
Uniwersyteckie Centrum Kliniczne ( Site 0170)
Gdansk, Pomeranian Voivodeship, 80-952
Szpital Wojewodzki w Poznaniu ( Site 0168)
Poznan, Greater Poland Voivodeship, 60-479
Pomorski Uniwersytet Medyczny ( Site 0167)
Szczecin, West Pomeranian Voivodeship, 70-111
Szpital Kliniczny Dzieciatka Jezus ( Site 0165)
Warsaw, Masovian Voivodeship, 02-006
Uniwersytecki Szpital Kliniczny im. Jana Mikulicza-Radeckiego ( Site 0162)
Wroclaw, Lower Silesian Voivodeship, 50-556
Hungary4 sites
Semmelweis Egyetem ( Site 0281)
Budapest, 1082
Debreceni Egyetem. ( Site 0283)
Debrecen, 4032
Pecsi Tudomanyegyetem AOK ( Site 0282)
Pécs, Baranya, 7624
Szegedi Tudomanyegyetem ( Site 0284)
Szeged, Csongrád megye, 6725
Italy4 sites
IRCCS Ospedale San Raffaele di Milano ( Site 0098)
Milan, 20132
Azienda Ospedaliera di Padova U.O.C. Trapianti Rene e Pancreas ( Site 0091)
Padova, Veneto, 35128
Policlinico Gemelli Instituto di Clinica Chirurgica ( Site 0093)
Roma, 00168
A.O.U. Citta della Salute e della Scienza di Torino ( Site 0096)
Turin, Piedmont, 10126
Belgium3 sites
Cliniques Universitaires de Bruxelles - CUB - Hopital Erasme ( Site 0042)
Brussels, Bruxelles-Capitale, Region de, 1070
Universitair Ziekenhuis Antwerpen ( Site 0041)
Edegem, Antwerpen, 2650
UZ Leuven - Campus Gasthuisberg ( Site 0044)
Leuven, Vlaams-Brabant, 3000
Germany3 sites
Charite Universitaetsmedizin Berlin ( Site 0071)
Berlin, 10117
Universitaetsklinikum Essen ( Site 0074)
Essen, North Rhine-Westphalia, 45147
Medizinische Hochschule Hannover ( Site 0073)
Hanover, Lower Saxony, 30625
Austria2 sites
Medizinische Universitat Innsbruck ( Site 0033)
Innsbruck, Tyrol, 6020
Allgemeines Krankenhaus Universitaetskliniken Wien ( Site 0032)
Vienna, 1090
United Kingdom2 sites
Queen Elizabeth Hospital ( Site 0356)
Birmingham, B15 2GW
St Georges University Hospitals NHS Foundation Trust. ( Site 0136)
London, London, City of, SW17 0QT
About this study
Official title: A Phase III, Randomized, Double-Blind, Active Comparator-Controlled Study to Evaluate the Efficacy and Safety of MK-8228 (Letermovir) Versus Valganciclovir for the Prevention of Human Cytomegalovirus (CMV) Disease in Adult Kidney Transplant Recipients
The primary objective of this study is to evaluate the efficacy of letermovir (LET) versus valganciclovir (VGCV) in preventing CMV disease in adult kidney transplant recipients. The primary hypotheses are that LET is non-inferior to VGCV; and if non-inferiority is demonstrated, that LET is superior to VGCV, in preventing CMV disease through 52 weeks post-transplant.
- Conditions
- CMV Disease
- Being tested
- Letermovir, Valganciclovir, Acyclovir (ACV), Placebo to ACV, Placebo to LET
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
LetermovirDrug
LET 480mg (or 240 mg when administered concomitantly with cyclosporin A) once daily for 28 weeks
ValganciclovirDrug
900 mg VGCV tablet orally, once daily for 28 weeks
Acyclovir (ACV)Drug
400 mg over-encapsulated ACV tablet orally, every 12 hours for 28 weeks
Placebo to ACVDrug
Over-encapsulated placebo tablet orally, every 12 hours for 28 weeks
Placebo to LETDrug
Placebo to LET tablet orally, once daily for 28 weeks
Placebo to VGCVDrug
Placebo to VGCV tablet orally, once daily for 28 weeks
| Study group | Role | What they receive |
|---|---|---|
| Letermovir | Experimental | LET 480mg (or 240 mg when administered concomitantly with cyclosporin A) tablet orally; placebo to VGCV tablet orally once daily; and 400 mg capsule of acyclovir (ACV) orally every 12 hours for 28 weeks Receives: Drug: Letermovir; Drug: Acyclovir (ACV); Drug: Placebo to VGCV |
| Valganciclovir | Active comparator | 900 mg VGCV tablet orally, once daily; placebo to LET tablet orally once daily; and placebo to ACV orally every 12 hours for 28 weeks Receives: Drug: Valganciclovir; Drug: Placebo to ACV; Drug: Placebo to LET |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants With Adjudicated Cytomegalovirus (CMV) Disease Through 52 Weeks Post-transplant
CMV disease was defined as the presence of either CMV end-organ disease or CMV syndrome and was confirmed by an independent, blinded Clinical Adjudication Committee (CAC). Only CAC-confirmed ("adjudicated") cases were included in percentage of participants who met the endpoint. Investigator-assessed cases which were not confirmed by the CAC were not included.
Measured: Up to 52 weeks
Secondary outcomes (4)
Percentage of Participants With Adjudicated CMV Disease Through 28 Weeks Post-transplant
CMV disease was defined as the presence of either CMV end-organ disease or CMV syndrome and was confirmed by an independent, blinded CAC. Only CAC-confirmed ("adjudicated") cases were included in percentage of participants who met the endpoint. Investigator-assessed cases which were not confirmed by the CAC were not included.
Measured: Up to 28 weeks
Time to Onset of Adjudicated CMV Disease Through 52 Weeks Post-transplant
The time to onset of adjudicated CMV disease was calculated in days, from the day of randomization to the day of onset of CMV disease as determined by the CAC.
Measured: Up to 52 weeks
Percentage of Participants With Any AE
An AE was defined as any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An AE could 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, was also an AE.
Measured: Up to 52 weeks
Percentage of Participants With Any Drug-related Serious Adverse Event (SAE)
An SAE was an AE that resulted in death, was life threatening, resulted in persistent or significant disability/incapacity, resulted in or prolonged an existing inpatient hospitalization, was a congenital anomaly/birth defect, was a cancer, was associated with an overdose, was another important medical event. SAEs that the investigator determined the relationship of the AE to the treatment as at least possibly related were reported.
Measured: Up to 52 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Feb 2018
- Study start3 May 2018
- Primary completion5 Apr 2022
- Study completion5 Apr 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for CMV DiseaseStudies of the same condition, open and under way.
- More trials run by Merck Sharp & Dohme LLCThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 601 participants (actual)
Sponsor and investigators
- Lead sponsor
- Merck Sharp & Dohme LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, Merck Sharp & Dohme LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03443869
- Sponsor's protocol ID
- 8228-002
- Other IDs
- MK-8228-002, 2017-001055-30, 2017
- Status last verified
- Jul 2023
- First submitted
- 19 Feb 2018
- Last updated
- 28 Jul 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
Publications
Limaye AP, Budde K, Humar A, Vincenti F, Kuypers DRJ, Carroll RP, Stauffer N, Murata Y, Strizki JM, Teal VL, Gilbert CL, Haber BA. Letermovir vs Valganciclovir for Prophylaxis of Cytomegalovirus in High-Risk Kidney Transplant Recipients: A Randomized Clinical Trial. JAMA. 2023 Jul 3;330(1):33-42. doi: 10.1001/jama.2023.9106.
PubMed 37279999Bunnapradist S, Vincenti F, Witzke O, Schneeberger S, Nguyen MH, Broyde N, Gilbert CL, Haber B. Favorable Adherence and Tolerability of Letermovir Versus Valganciclovir for Cytomegalovirus Prophylaxis in Kidney Transplant Recipients Aged 65 y or Older: Findings From a Randomized, Phase 3 Trial. Transplant Direct. 2026 Aug 21;12(9):e1990. doi: 10.1097/TXD.0000000000001990. eCollection 2026 Sep.
PubMed 42639594Limaye AP, Crespo M, Kamar N, Humar A, Carroll RP, Pereira MR, Broyde N, Wang W, Haber B. Cytomegalovirus (CMV)-Specific Cell-Mediated Immunity for Prediction of Postprophylaxis CMV Disease in a Phase 3 Trial of Letermovir Versus Valganciclovir Prophylaxis in Donor CMV-Seropositive/Recipient CMV-Seronegative Kidney Transplant Recipients. Clin Infect Dis. 2026 Feb 25;82(2):e316-e324. doi: 10.1093/cid/ciaf632.
PubMed 41321121Strizki JM, Diamond TL, Teal VL, Gilbert CL, Wang W, Stauffer N, Haber BA. Cytomegalovirus Antiviral Resistance Among Kidney Transplant Recipients in a Phase 3 Trial of Letermovir vs Valganciclovir Prophylaxis. J Infect Dis. 2024 Dec 16;230(6):e1287-e1298. doi: 10.1093/infdis/jiae287.
PubMed 38853607Vernooij RW, Michael M, Ladhani M, Webster AC, Strippoli GF, Craig JC, Hodson EM. Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients. Cochrane Database Syst Rev. 2024 May 3;5(5):CD003774. doi: 10.1002/14651858.CD003774.pub5.
PubMed 38700045
Study at a glance
From the registry record, last updated by the sponsor on 28 Jul 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III, Randomized, Double-Blind, Active Comparator-Controlled Study to Evaluate the Efficacy and Safety of MK-8228 (Letermovir) Versus Valganciclovir for the Prevention of Human Cytomegalovirus (CMV) Disease in Adult Kidney Transplant Recipients
- ClinicalTrials.gov ID
- NCT03443869
- Acronym / sponsor ID
- 8228-002
- Conditions
- CMV Disease
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 601 participants (actual)
- Lead sponsor
- Merck Sharp & Dohme LLCIndustry (pharma, biotech, devices)
- Study start
- 3 May 2018 (actual)
- Primary completion
- 5 Apr 2022 (actual)
- Study completion
- 5 Apr 2022 (actual)
- First posted
- 23 Feb 2018 (actual)
- Results
- Posted 14 Apr 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary objective of this study is to evaluate the efficacy of letermovir (LET) versus valganciclovir (VGCV) in preventing CMV disease in adult kidney transplant recipients. The primary hypotheses are that LET is non-inferior to VGCV; and if non-inferiority is demonstrated, that LET is superior to VGCV, in preventing CMV disease through 52 weeks post-transplant.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Letermovir | Experimental | Drug: Letermovir, Drug: Acyclovir (ACV), Drug: Placebo to VGCVLET 480mg (or 240 mg when administered concomitantly with cyclosporin A) tablet orally; placebo to VGCV tablet orally once daily; and 400 mg capsule of acyclovir (ACV) orally every 12 hours for 28 weeks |
| Valganciclovir | Active comparator | Drug: Valganciclovir, Drug: Placebo to ACV, Drug: Placebo to LET900 mg VGCV tablet orally, once daily; placebo to LET tablet orally once daily; and placebo to ACV orally every 12 hours for 28 weeks |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Have a documented negative serostatus for CMV within 180 days prior to randomization.
- Anticipate receiving a primary or secondary allograft kidney from a CMV IgG seropositive (D+) donor at the time of screening AND have received a primary or secondary allograft kidney from a documented D+ donor at the time of randomization.
- Be within 0 (i.e. day of transplantation) to 7 days (inclusive) post-kidney transplant at the time of randomization.
- Males agree to use contraception during the treatment period, and for at least 90 days after the last dose of study treatment, and refrain from donating sperm during this period.
- Female is not pregnant, not breastfeeding, and is not a woman of childbearing potential (WOCBP), OR if a WOCBP, agrees to follow the contraception guidance during the treatment period and for at least 90 days after the last dose of study treatment.
Key exclusion criteria (19 listed)
- Has received a previous solid organ transplant or hematopoietic stem cell transplant (HSCT). Note: Participants who have received a prior primary allograft kidney may be enrolled, provided that all other inclusion/exclusion criteria are met.
- Is a multi-organ transplant recipient (e.g. kidney-pancreas). Double kidney transplant recipients (i.e. transplant of two kidneys from the same donor to the same recipient simultaneously) will be excluded.
- Has a history of CMV disease or suspected CMV disease within 6 months prior to randomization.
- Has suspected or known hypersensitivity to active or inactive ingredients of LET formulations, VGCV, GCV, and/or ACV formulations.
- Is on dialysis or plasmapheresis at the time of randomization. Dialysis includes hemofiltration.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| LetermovirLET 480mg (or 240 mg when administered concomitantly with cyclosporin A) once daily for 28 weeks | Drug | Letermovir |
| Valganciclovir900 mg VGCV tablet orally, once daily for 28 weeks | Drug | Valganciclovir |
| Acyclovir (ACV)400 mg over-encapsulated ACV tablet orally, every 12 hours for 28 weeks | Drug | Letermovir |
| Placebo to ACVOver-encapsulated placebo tablet orally, every 12 hours for 28 weeks | Drug | Valganciclovir |
| Placebo to LETPlacebo to LET tablet orally, once daily for 28 weeks | Drug | Valganciclovir |
| Placebo to VGCVPlacebo to VGCV tablet orally, once daily for 28 weeks | Drug | Letermovir |
Primary outcome
Percentage of Participants With Adjudicated Cytomegalovirus (CMV) Disease Through 52 Weeks Post-transplant
Time frame: Up to 52 weeks
CMV disease was defined as the presence of either CMV end-organ disease or CMV syndrome and was confirmed by an independent, blinded Clinical Adjudication Committee (CAC). Only CAC-confirmed ("adjudicated") cases were included in percentage of participants who met the endpoint. Investigator-assessed cases which were not confirmed by the CAC were not included.
4 secondary outcomes
Percentage of Participants With Adjudicated CMV Disease Through 28 Weeks Post-transplant
Time frame: Up to 28 weeks
Time to Onset of Adjudicated CMV Disease Through 52 Weeks Post-transplant
Time frame: Up to 52 weeks
Percentage of Participants With Any AE
Time frame: Up to 52 weeks
Percentage of Participants With Any Drug-related Serious Adverse Event (SAE)
Time frame: Up to 52 weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Jul 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 37279999Limaye AP, Budde K, Humar A, Vincenti F, Kuypers DRJ, Carroll RP, Stauffer N, Murata Y, Strizki JM, Teal VL, Gilbert CL, Haber BA. Letermovir vs Valganciclovir for Prophylaxis of Cytomegalovirus in High-Risk Kidney Transplant Recipients: A Randomized Clinical Trial. JAMA. 2023 Jul 3;330(1):33-42. doi: 10.1001/jama.2023.9106.
- Derived from this study: PubMed 42639594Bunnapradist S, Vincenti F, Witzke O, Schneeberger S, Nguyen MH, Broyde N, Gilbert CL, Haber B. Favorable Adherence and Tolerability of Letermovir Versus Valganciclovir for Cytomegalovirus Prophylaxis in Kidney Transplant Recipients Aged 65 y or Older: Findings From a Randomized, Phase 3 Trial. Transplant Direct. 2026 Aug 21;12(9):e1990. doi: 10.1097/TXD.0000000000001990. eCollection 2026 Sep.
- Derived from this study: PubMed 41321121Limaye AP, Crespo M, Kamar N, Humar A, Carroll RP, Pereira MR, Broyde N, Wang W, Haber B. Cytomegalovirus (CMV)-Specific Cell-Mediated Immunity for Prediction of Postprophylaxis CMV Disease in a Phase 3 Trial of Letermovir Versus Valganciclovir Prophylaxis in Donor CMV-Seropositive/Recipient CMV-Seronegative Kidney Transplant Recipients. Clin Infect Dis. 2026 Feb 25;82(2):e316-e324. doi: 10.1093/cid/ciaf632.
- Derived from this study: PubMed 38853607Strizki JM, Diamond TL, Teal VL, Gilbert CL, Wang W, Stauffer N, Haber BA. Cytomegalovirus Antiviral Resistance Among Kidney Transplant Recipients in a Phase 3 Trial of Letermovir vs Valganciclovir Prophylaxis. J Infect Dis. 2024 Dec 16;230(6):e1287-e1298. doi: 10.1093/infdis/jiae287.
- Derived from this study: PubMed 38700045Vernooij RW, Michael M, Ladhani M, Webster AC, Strippoli GF, Craig JC, Hodson EM. Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients. Cochrane Database Syst Rev. 2024 May 3;5(5):CD003774. doi: 10.1002/14651858.CD003774.pub5.
- Merck Clinical Trial InformationLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Medical Director study director
Merck Sharp & Dohme LLC
94 sites in 16 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Letermovir, Valganciclovir and Acyclovir (ACV) in people with CMV Disease, run by Merck Sharp & Dohme LLC at 94 sites in 16 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 28 Jul 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 94 sites in United States, Colombia, France, Argentina, Australia and 11 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 14 Apr 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percentage of Participants With Adjudicated Cytomegalovirus (CMV) Disease Through 52 Weeks Post-transplant (time frame: Up to 52 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03443869, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jul 2023.