Rev Esp Quimioter 2023; 36(5): 526-530

In vitro assessment of the combined effect of letermovir and sirolimus on cytomegalovirus replication

ESTELA GIMÉNEZ, MANUEL GUERREIRO, ROBERTO GOZALBO-ROVIRA, CRISTOBAL AGUILAR, ELISEO ALBERT, JOSÉ LUIS PIÑANA, CARLOS SOLANO, DAVID NAVARRO

Published: 28 June 2023

http://www.doi.org/10.37201/req/016.2023

Introduction. Letermovir (LMV) is used for prophylaxis of cytomegalovirus (CMV) reactivation and end-organ disease in adult CMV-seropositive allogeneic hematopoietic stem cell transplant recipients (allo-HSCT). In turn, sirolimus (SLM) which displays in vitro anti-CMV activity, is frequently employed for prophylaxis of Graft vs. Host disease in allo-HSCT. Here, we aimed at assessing whether LMV and SLM used in combination may act synergistically in vitro on inhibiting CMV replication.
Material and methods. The antiviral activity of LMV and SLM alone or in combination was evaluated by a checkerboard assay, using ARPE-19 cells infected with CMV strain BADrUL131-Y. LMV and SLM were used at concentrations ranging from 24 nM to 0.38 nM and 16 nM to 0.06 nM, respectively.
Results. The mean EC50 for LMV and SLM was 2.44 nM (95% CI, 1.66-3.60) and 1.40 nM (95% CI, 0.41-4.74), respective. LMV and SLM interaction yielded mainly additive effects over the range of concentrations tested.
Conclusion. The additive nature of the combination of LMV and SLM against CMV may have relevant clinical
implications in management of CMV infection in allo-HSCT recipients undergoing prophylaxis with LMV.

Rev Esp Quimioter 2023; 36(5): 526-530 [Full-text PDF]