Verghese Priya S, Schleiss Mark R
University of Minnesota Medical School Department of Pediatrics, Division of Pediatric Nephrology, Amplatz Children's Hospital, East Building, MB680, 2414 South 7th Street, Minneapolis, MN 55454, .
Drugs Future. 2013 May;38(5):291-298. doi: 10.1358/dof.2013.038.05.1946425.
Novel therapies are urgently needed for the management of cytomegalovirus (CMV) disease in high-risk patients. Currently licensed agents target the viral DNA polymerase, and although they are effective, they are fraught with toxicities to patients. Moreover, emergence of antiviral resistance is an increasing problem, particularly for patients on long-term suppressive therapy. A new agent, letermovir (AIC246), shows great promise for the management of CMV infection. Advantages include its good oral bioavailability, its lack of toxicity, and the apparent absence of drug-drug interactions. Letermovir has a novel mechanism of action, exerting its antiviral effect by interfering with the viral pUL56 gene product and in the process disrupting the viral terminase complex. This agent demonstrates substantial promise as an alternative to more toxic antivirals in patients at high risk for CMV disease, particularly in the transplantation setting.
对于高危患者巨细胞病毒（CMV）疾病的管理，迫切需要新的治疗方法。目前已获许可的药物靶向病毒DNA聚合酶，虽然它们有效，但对患者存在诸多毒性。此外，抗病毒耐药性的出现是一个日益严重的问题，尤其是对于接受长期抑制治疗的患者。一种新型药物来特莫韦（AIC246）在CMV感染的管理方面显示出巨大潜力。其优势包括良好的口服生物利用度、无毒性以及明显不存在药物相互作用。来特莫韦具有独特的作用机制，通过干扰病毒pUL56基因产物并在此过程中破坏病毒末端酶复合物来发挥抗病毒作用。在CMV疾病高危患者中，尤其是在移植环境中，作为毒性更大的抗病毒药物的替代品，这种药物显示出巨大的前景。
