%A Raval,Amit D. %A Ganz,Michael L. %A Fraeman,Kathy %A Lorden,Andrea L. %A Saravanan,Shanmugapriya %A Tang,Yuexin %A Santos,Carlos A. Q. %D 2022 %J Transplant International %C %F %G English %K kidney transplantation,antiviral,cytomegalovirus,prophylaxis,pharmacoepidemiology %Q %R 10.3389/ti.2022.10528 %W %L %M %P %7 %8 2022-August-12 %9 Original Research %# %! CMV antivirals in adult kidney transplant recipients %* %< %T Real-World Treatment Patterns of Antiviral Prophylaxis for Cytomegalovirus Among Adult Kidney Transplant Recipients: A Linked USRDS-Medicare Database Study %U https://www.frontierspartnerships.org/articles/10.3389/ti.2022.10528 %V 35 %0 JOURNAL ARTICLE %@ 1432-2277 %X Limited data exist on cytomegalovirus (CMV) antiviral treatment patterns among kidney transplant recipients (KTRs). Using United States Renal Database System registry data and Medicare claims (1 January 2011–31 December 2017), we examined CMV antiviral use in 20,601 KTRs who received their first KT from 2011 to 2016. Three-quarters of KTRs started CMV prophylaxis (86.9% of high-, 83.6% of intermediate-, and 31.7% of low-risk KTRs). Median time to prophylaxis discontinuation was 121, 90, and 90 days for high-, intermediate-, and low-risk KTRs, respectively. Factors associated with receiving CMV prophylaxis were high-risk status, diabetes, receipt of a well-functioning kidney graft, greater time on dialysis before KT, panel reactive antibodies ≥80%, and use of antithymocyte globulin, alemtuzumab, and tacrolimus. KTRs were more likely to discontinue CMV prophylaxis if they developed leukopenia/neutropenia, had liver disease, or had a deceased donor. These findings suggest that adherence to the recommended duration of CMV-prophylaxis for high and intermediate-risk patients is suboptimal, and CMV prophylaxis is overused in low-risk patients.