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Opportunities to help patient outcomes through post-transplant infection mitigation

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September 30, 2021

Imagine being severely ill and the only way to feel better is an organ or stem cell transplant. While transplantation often gives patients hope, this hope comes with burden and challenges.1 For some, receiving a transplant is a chance of a new life; for others, it’s their only chance of life. And this chance comes with complications.2,3

One of the most common post-transplant complications is cytomegalovirus, or CMV, which is a beta herpes virus that persists in the body after an initial infection.4-6 For healthy people, CMV doesn’t cause symptoms, but for patients who have undergone a transplant—whether it’s a solid organ transplant or stem cell transplant—they may be faced with an immunosuppressed state putting them at risk for CMV infection.4-6 Immunosuppression is necessary because it prevents rejection and protects the organ or stem cell transplant.7 But it’s also challenging because it compromises the patient’s immune system, which increases the risk of infection.7 Due to the weakened immune system, 16-56% of solid organ transplant patients and 30-70% of stem cell transplant patients might experience a CMV infection.8,9 A CMV infection can lead to severe consequences, including the loss of the transplanted organ and failure of the graft, or in extreme cases, it can be fatal4,6

“Patients face enormous challenges on many different levels when they receive a transplant,” said Tien Bo, Unit Head, Transplant & New Programs of the Rare Genetic & Hematology Global Medical Affairs Team. “First, they have to overcome their primary disease. Second, they have to overcome the actual process of transplantation itself. And third, they have to overcome the challenges associated with post-transplant complications, like CMV, that threaten the very transplant that they have endured. And finally, they need to overcome the recovery process.”

The prevention, diagnosis and management of infectious diseases, like CMV, are critical to the overall management in transplant patients.10,11 Likewise, greater awareness of the unmet needs of transplant patients should remain at the forefront of patient care—not just leading up to transplant surgery, but also in the post-transplant setting.

Taking on CMV together

The journey to tackling CMV infection in post-transplant patients has been a long and challenging one. But at Takeda, we are dedicated to supporting transplant patients through their journey.

“We have an unwavering commitment to making a positive impact in the transplant community,” said Obi Umeh, Global Program Lead, Rare Genetic and Hematology Therapeutic Area Unit at Takeda. “Our team has remained dedicated, passionate and resilient in supporting transplant patients by continuing to invest in this space and help advance our research efforts.”

When Takeda acquired Shire in 2019,12 Takeda’s leadership team met with the clinical and medical team to understand what CMV was and what the threat of a potential infection could mean to a transplant patient. With the patients in mind, a decision was made to continue to better understand this unmet need. Along with an active partnership with the scientific and medical community, our team has been working tirelessly to support these patients.

“I’m so proud of the work our team has been doing to address this unmet need,” said Martha Fournier, Executive Medical Director at Takeda. “Our dedicated team of scientists have worked so hard to find innovative ways to help address challenges and be able to help patients on their transplantation journey.”

CMV continues to be a significant challenge for transplant surgeons and their patients, but current information on this disease is emerging every day. To learn more, visit Takeda.com


References

  1. Yang F-C, et al. The difficulties and needs of organ transplant recipients during postoperative care at home: a systematic review. Int J Environ Res Public Health. 2020;17(16):5798. doi:10.3390/ijerph17165798
  2. Sen A, et al. Complications of solid organ transplantation. Critical Care Clinics. 2019;35(1):169-186. doi:10.1016/j.ccc.2018.08.011
  3. Tabbara IA, et al. Allogeneic hematopoietic stem cell transplantation: complications and results. Archives of Internal Medicine. 2002;162(14):1558-1566. doi:10.1001/archinte.162.14.1558
  4. Azevedo LS, et al. Cytomegalovirus infection in transplant recipients. Clinics. 2015;70(7):515-523. doi:10.6061/clinics/2015(07)09
  5. Forte E, et al. Cytomegalovirus latency and reactivation: an intricate interplay with the host immune response. Front Cell Infect Microbiol. 2020;10:130. doi:10.3389/fcimb.2020.00130
  6. Kotton CN, et al. The third international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation: Transplantation. 2018;102(6):900-931. doi:10.1097/TP.0000000000002191
  7. Duncan MD, et al. Transplant-related immunosuppression. Proc Am Thorac Soc. 2005;2(5):449-455. doi:10.1513/pats.200507-073JS
  8. Styczynski J. Who is the patient at risk of CMV recurrence: a review of the current scientific evidence with a focus on hematopoietic cell transplantation. Infect Dis Ther. 2018;7(1):1-16.
  9. Cho S-Y, et al. Cytomegalovirus Infections after Hematopoietic Stem Cell Transplantation: Current Status and Future Immunotherapy. Int J Mol Sci. 2019;20(2666):1-17.
  10. Legendre C, et al. Improving outcomes for solid-organ transplant recipients at risk from cytomegalovirus infection: late-onset disease and indirect consequences. Clinical Infectious Diseases. 2008;46(5):732-740. doi:10.1086/527397
  11. Kotton CN. CMV: prevention, diagnosis and therapy. American Journal of Transplantation. 2013;13(s3):24-40. doi:10.1111/ajt.12006
  12. Takeda completes acquisition of Shire, becoming a global, values-based, R&D -driven biopharmaceutical leader. Accessed September 2, 2021. https://www.takeda.com/newsroom/newsreleases/2019/takeda-completes-acquisition-of-shire-becoming-a-global-values-based-rd-driven-biopharmaceutical-leader/