Zalmai Hakimi1, Samuel Aballéa2, Sameh Ferchichi2, Micky Scharn1, Isaac A Odeyemi3, Mondher Toumi4, Faouzi Saliba5. 1. HEOR, Astellas Pharma Global Development, Leiden, The Netherlands. 2. HEOR, Creativ-Ceutical, Paris, France. 3. HEOR, Astellas Pharma Europe Ltd., Chertsey, UK. 4. Research Unit 3279, Aix-Marseille University, Marseille, France. 5. AP-HP Hôpital Paul Brousse - Centre Hépato-Biliaire, Villejuif, France.
Abstract
BACKGROUND: We investigated the impact of early- (E-CMV) and late onset (L-CMV) cytomegalovirus disease on the probability of graft rejection, graft failure, mortality, and healthcare resource use, following solid organ transplantation (SOT) in France. METHODS: A retrospective analysis of data from the French 'Programme de Médicalisation des Systèmes d'Information' database (2007-2011) was conducted to identify SOT recipients who developed CMV disease in an inpatient setting. Recipients were stratified by time to CMV disease onset: E-CMV (≤3 months), L-CMV-3M (>3-24 months), and L-CMV-6M (>6-24 months). Data were analyzed by comparing recipients with CMV disease or without (controls) in a 1:2 ratio, matched according to age, gender, target organ, and previous/simultaneous occurrence of graft rejection. Graft failure, graft rejection, all-cause in-hospital mortality, and resource utilization (including hospitalization costs) were assessed over 12 months following CMV disease diagnosis. RESULTS: Among 20 473 SOT recipients, 2430 (11.86%) were reported to have CMV disease within 24 months after transplantation. CMV disease was significantly associated with an increased risk of graft rejection and mortality, as indicated by logistic regression analysis. Odd ratios (ORs) for the risk of graft rejection were E-CMV=1.43, L-CMV-3M=1.50, and L-CMV-6M=1.61 (all P<.05), while ORs for mortality were E-CMV=2.85, L-CMV-3M=4.22, and L-CMV-6M=4.77 (all P<.0001). Only L-CMV was significantly correlated with a higher risk of graft failure: E-CMV=1.18 (P=.1906), L-CMV-3M=1.77 (P=.0013), and L-CMV-6M=3.12 (P<.0001). Hospitalization costs increased by €7078 (range €6270-€22 111), €6523 (range €5328-€10 295), and €6311 (range €5295-€9184) in recipients with E-CMV, L-CMV-3M, and L-CMV-6-M, respectively. CONCLUSION: This study, based on French national data, demonstrates the considerable burden of CMV disease in SOT recipients and highlights the importance of developing new strategies to prevent and manage CMV disease and improve clinical outcomes for SOT patients.
BACKGROUND: We investigated the impact of early- (E-CMV) and late onset (L-CMV) cytomegalovirus disease on the probability of graft rejection, graft failure, mortality, and healthcare resource use, following solid organ transplantation (SOT) in France. METHODS: A retrospective analysis of data from the French 'Programme de Médicalisation des Systèmes d'Information' database (2007-2011) was conducted to identify SOT recipients who developed CMV disease in an inpatient setting. Recipients were stratified by time to CMV disease onset: E-CMV (≤3 months), L-CMV-3M (>3-24 months), and L-CMV-6M (>6-24 months). Data were analyzed by comparing recipients with CMV disease or without (controls) in a 1:2 ratio, matched according to age, gender, target organ, and previous/simultaneous occurrence of graft rejection. Graft failure, graft rejection, all-cause in-hospital mortality, and resource utilization (including hospitalization costs) were assessed over 12 months following CMV disease diagnosis. RESULTS: Among 20 473 SOT recipients, 2430 (11.86%) were reported to have CMV disease within 24 months after transplantation. CMV disease was significantly associated with an increased risk of graft rejection and mortality, as indicated by logistic regression analysis. Odd ratios (ORs) for the risk of graft rejection were E-CMV=1.43, L-CMV-3M=1.50, and L-CMV-6M=1.61 (all P<.05), while ORs for mortality were E-CMV=2.85, L-CMV-3M=4.22, and L-CMV-6M=4.77 (all P<.0001). Only L-CMV was significantly correlated with a higher risk of graft failure: E-CMV=1.18 (P=.1906), L-CMV-3M=1.77 (P=.0013), and L-CMV-6M=3.12 (P<.0001). Hospitalization costs increased by €7078 (range €6270-€22 111), €6523 (range €5328-€10 295), and €6311 (range €5295-€9184) in recipients with E-CMV, L-CMV-3M, and L-CMV-6-M, respectively. CONCLUSION: This study, based on French national data, demonstrates the considerable burden of CMV disease in SOT recipients and highlights the importance of developing new strategies to prevent and manage CMV disease and improve clinical outcomes for SOT patients.
Authors: Caleb Skipper; Mark R Schleiss; Ananta S Bangdiwala; Nelmary Hernandez-Alvarado; Kabanda Taseera; Henry W Nabeta; Abdu K Musubire; Sarah M Lofgren; Darin L Wiesner; Joshua Rhein; Radha Rajasingham; Charlotte Schutz; Graeme Meintjes; Conrad Muzoora; David B Meya; David R Boulware Journal: Clin Infect Dis Date: 2020-07-27 Impact factor: 9.079
Authors: Anne-Grete Märtson; Martijn Bakker; Hans Blokzijl; Erik A M Verschuuren; Stefan P Berger; Lambert F R Span; Tjip S van der Werf; Jan-Willem C Alffenaar Journal: BMJ Open Date: 2020-01-07 Impact factor: 2.692
Authors: Ramandeep Singh; Hessel Peters-Sengers; Ester B M Remmerswaal; Unsal Yapici; Karlijn A M I van der Pant; Neelke C van der Weerd; Joris J T H Roelofs; René A W van Lier; Fréderike J Bemelman; Sandrine Florquin; Ineke J M Ten Berge Journal: Transpl Int Date: 2020-07-04 Impact factor: 3.782