A Study to Evaluate the Safety and Tolerability, Pharmacokinetics, and Antiviral Activity of Maribavir for the Treatment of Children and Teenage Transplant Recipients With CMV Infection

• Status: Not yet recruiting
• Trial end date: 2027-02-17
• Target enrollment: 0
• Participant gender: All

Summary

The main aim of this study is to find out the safety, tolerability and pharmacokinetics (PK) of maribavir for the treatment of CMV infection in children and teenagers after HSCT or SOT and to identify the optimal dose of maribavir using a 200 milligrams (mg) adult tablet formulation or other formulation based on PK modeling.

The participants will be treated with maribavir for 8 weeks.

Participants need to visit their doctor during 12-week follow-up period.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Takeda
• Collaborator: Takeda Development Center Americas, Inc.
• Treatments: Maribavir

Criteria

Inclusion Criteria:

• Parent/both parents or legally authorized representative (LAR) must provide signature of informed consent and there must be documentation of assent by the participant, as age appropriate, before completing any study-related procedures. During the COVID-19 public health emergency, informed consent from a potential or current trial participant may, if permitted by local laws and regulations, be obtained via electronic informed consent capabilities or an electronic face-to-face consent interview when these individuals are unable to travel to the site.

• Be a male or female child or adolescent < 18 years of age at the time of consent. For participants in Cohort 3 only, must have a gestational age of at least 38 weeks and a minimum weight of 5 kg.

• Be a recipient of an SOT or an HSCT that is functioning at the time of screening.

• Have a documented CMV infection, with a CMV deoxyribonucleic acid (DNA) screening value of >= 1365 International Units per milliliter (IU/mL) in whole blood or >= 455 IU/mL in plasma in 2 consecutive assessments within 14 days of first dose of study drug, separated by at least 1 day, by quantitative polymerase chain reaction (qPCR) or comparable quantitative CMV DNA results.

• Have all the following results as part of screening laboratory assessments:

• Absolute neutrophil count >= 500 per cubic millimeter (/mm^3) (0.5 × 10^9 per liter [/L])

• Platelet count >= 15,000/mm^3 (15 × 10^9/L)

• Hemoglobin >= 7 grams per deciliter (g/dL)

• Have an estimated glomerular filtration rate (creatinine-based Bedside Schwartz equation) >= 30 milliliters per minute (mL/min) /1.73 meter square (m^2).

• Be a female of nonchildbearing potential. If a female of childbearing potential, have a negative serum human chorionic gonadotropin (hCG) or beta-human chorionic gonadotropin (β-hCG) pregnancy test at screening. Males, or nonpregnant, nonlactating females who are sexually active must agree to comply with the applicable contraceptive requirements of this protocol during the study treatment administration period and for 90 days after the last dose of study treatment.

• Have life expectancy of >= 8 weeks.

• Be willing and have an understanding and ability to fully comply with the study procedures and restrictions defined in the protocol. For younger children, the parent/both parents or LAR must meet this criterion.

Exclusion Criteria:

• Have CMV tissue invasive disease involving the central nervous system (CNS) or retina as assessed by the investigator at the time of screening.

• Have uncontrolled other type of infection as assessed by the investigator on the date of enrollment.

• Have a history of clinically relevant alcohol or drug abuse that may interfere with treatment compliance or assessments with the protocol as determined by the investigator.

• Be receiving valganciclovir, ganciclovir, cidofovir, foscarnet, leflunomide, letermovir, or artesunate when study treatment is initiated, or anticipated to require one of these agents during the 8-week treatment period.

• Have a known hypersensitivity to maribavir or to any excipients.

• Have severe vomiting, diarrhea, or other severe GI illness within 24 hours prior to the first dose of study treatment or a GI absorption abnormality that would preclude administration of oral medication.

• Require mechanical ventilation or vasopressors for hemodynamic support at baseline (Visit 2/Day 0/Week 0).

• Be pregnant (or expecting to conceive) or nursing.

• Have previously completed, discontinued, or have been withdrawn from this study.

• Have received any investigational agent or device within 30 days before initiation of study treatment (includes any investigational agent with known anti-CMV activity, and CMV specific T-cells). Previously approved agents under investigation for additional indications are not exclusionary.

• Have previously received maribavir or CMV vaccine at any time.

• Have any clinically significant medical or surgical condition that, in the investigator's opinion, could interfere with interpretation of study results, contraindicate the administration of the assigned study treatment, or compromise the safety or well-being of the participant.

• Have severe liver disease (Child-Pugh score of >= 10).

• Have serum aspartate aminotransferase greater than (>) 5 times upper limit of normal (ULN) at screening, or serum alanine aminotransferase > 5 times ULN at screening, or total bilirubin >= 3.0 times ULN at screening (except for documented Gilbert's syndrome), as analyzed by local laboratory.

• Have known (previously documented) positive results for human immunodeficiency virus (HIV). Participants must have a confirmed negative HIV test result within 3 months of study entry or, if unavailable, be tested by a local laboratory during the screening period.

• Have active malignancy with the exception of nonmelanoma skin cancer, as determined by the investigator. Participants who experience relapse or progression of their underlying malignancy (for which HSCT or SOT was performed), as determined by the investigator, are not to be enrolled.

• Be undergoing treatment for acute or chronic hepatitis B or hepatitis C.