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TOPLINE:

Maribavir achieved cytomegalovirus (CMV) resolution in a notable proportion of hematopoietic cell transplant (HCT) recipients receiving preemptive treatment or treatment for CMV disease and was generally well tolerated. 

METHODOLOGY:

• Researchers conducted a retrospective study using real-world data from 15 European countries to evaluate outcomes associated with maribavir for the treatment of CMV infection or disease in HCT recipients.
• They analyzed 118 recipients (109 adults and 9 children; 63% male) who received 126 maribavir treatment courses between December 2022 and January 2025, after its commercial approval (2022).
• Maribavir was most often given as second- or third-line therapy; the median duration of treatment was 7.9 weeks.
• The primary objective was to evaluate response to treatment at 12 weeks, with CMV resolution and treatment failure assessed as outcomes.
• Secondary objectives included assessments of reasons for discontinuation, overall survival, and nonrelapse mortality at 12 weeks.

TAKEAWAY:

• CMV resolution occurred in 81% of 109 preemptive treatment courses and 71% of 17 courses for CMV disease; the corresponding rates of treatment failure were 17% and 12%, respectively.
• Overall survival at 12 weeks after maribavir initiation was 82%, with a median survival time of 256 days; the nonrelapse mortality rate at 12 weeks was 15%.
• During preemptive treatment courses, end-organ CMV disease — including proven CMV pneumonia, CMV gastrointestinal disease, probable CMV retinitis, and probable CMV encephalitis — occurred in 5% of courses.
• The reasons for discontinuing maribavir included end of planned treatment course (71%), death (10%), and side effects (2%).

IN PRACTICE:

“Maribavir showed high response rates with minimal toxicity, supporting its role as a valuable therapeutic option in refractory and resistant cases or cases limited by expected toxicity from other antiviral agents,” the authors wrote. 

SOURCE:

The study was led by Annalisa Paviglianiti, MD, PhD, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Sant Pau and José Carreras Leukemia Research Institutes, Universitat Autónoma de Barcelona, Barcelona, Spain. It was published online on April 17, 2026, in The Lancet Infectious Diseases.

LIMITATIONS:

The retrospective design introduced variability in maribavir use, monitoring, and clinical decision-making across centers. Detailed toxicity data were not captured; therefore, adverse events may have been underreported. Resistance testing was performed in a small subset of patients, limiting conclusions about the prevalence of maribavir resistance in clinical practice.

DISCLOSURES:

The study did not receive any funding. Several authors reported receiving consulting fees, speaker’s fees, research grants, travel support, lecture honoraria, or support for attending meetings from; participating on advisory boards of; or having other ties with various pharmaceutical companies and organizations, including Medscape/WebMD.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.