{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:52:01Z","timestamp":1791287521027,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T00:00:00Z","timestamp":1705881600000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Translational Sci"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Maribavir is an oral benzimidazole riboside for treatment of post\u2010transplant cytomegalovirus (CMV) infection\/disease that is refractory to prior antiviral treatment (with or without resistance). Through competitive inhibition of adenosine triphosphate, maribavir prevents the phosphorylation actions of UL97 to inhibit CMV DNA replication, encapsidation, and nuclear egress. Maribavir is active against CMV strains with viral DNA polymerase mutations that confer resistance to other CMV antivirals. After oral administration, maribavir is rapidly and highly absorbed (fraction absorbed &gt;90%). The approved dose of 400\u2009mg twice daily (b.i.d.) achieves a steady\u2010state area under the curve per dosing interval of 128\u2009h*\u03bcg\/mL and trough concentration of 4.90\u2009\u03bcg\/mL (13.0\u2009\u03bcM). Maribavir is highly bound to human plasma proteins (98%) with a small apparent volume of distribution of 27.3\u2009L. Maribavir is primarily cleared by hepatic CYP3A4 metabolism; its major metabolite, VP44669 (pharmacologically inactive), is excreted in the urine and feces. There is no clinically relevant impact on maribavir pharmacokinetics by age, sex, race\/ethnicity, body weight, transplant type, or hepatic\/renal impairment status. In phase II dose\u2010ranging studies, maribavir showed similar rates of CMV viral clearance across 400, 800, or 1200\u2009mg b.i.d. groups, ranging from 62.5\u201370% in study 202 (NCT01611974) and 74\u201383% in study 203 (EudraCT 2010\u2013024247\u201032). In the phase III SOLSTICE trial (NCT02931539), maribavir 400\u2009mg b.i.d. demonstrated superior CMV viremia clearance at week 8 versus investigator\u2010assigned treatments, with lower treatment discontinuation rates. Dysgeusia, nausea, vomiting, and diarrhea were commonly experienced adverse events among patients treated with maribavir in clinical trials.<\/jats:p>","DOI":"10.1111\/cts.13696","type":"journal-article","created":{"date-parts":[[2023,12,10]],"date-time":"2023-12-10T06:03:36Z","timestamp":1702188216000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Maribavir: Mechanism of action, clinical, and translational science"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3580-6365","authenticated-orcid":false,"given":"Kefeng","family":"Sun","sequence":"first","affiliation":[{"name":"Quantitative Clinical Pharmacology Takeda Development Center Americas, Inc.  Lexington Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2289-0847","authenticated-orcid":false,"given":"Martha","family":"Fournier","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Rare Genetics &amp; Hematology Therapeutic Area Unit Takeda Development Center Americas, Inc.  Lexington Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7739-3135","authenticated-orcid":false,"given":"Aimee K.","family":"Sundberg","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Rare Genetics &amp; Hematology Therapeutic Area Unit Takeda Development Center Americas, Inc.  Lexington Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6624-4791","authenticated-orcid":false,"given":"Ivy H.","family":"Song","sequence":"additional","affiliation":[{"name":"Quantitative Clinical Pharmacology Takeda Development Center Americas, Inc.  Lexington Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-021-00582-z"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8040515"},{"key":"e_1_2_11_4_1","unstructured":"Takeda Pharmaceuticals America Inc.LIVTENCITY US prescribing information. 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