Multidisciplinary Team Essentials on CMV Prevention, Surveillance, and Treatment Optimization in the Transplant Setting

Provided by the Academy for Continued Healthcare Learning (ACHL).

Supported by an educational grant from Merck & Co., Inc.

RELEASE DATE

July 8, 2024

Expiration Date

July 8, 2025

ACTIVITY OVERVIEW

Multidisciplinary teams must interpret and apply the latest guidance and evidence for the prevention and treatment of CMV infections following solid organ or hematopoietic stem cell transplant. Customized learning responsive to each learner’s area of expertise and educational needs provides targeted content and resources to help clinicians enhance their practices and improve patient outcomes.

Do you specialize in hematopoietic cell transplant (HCT)?

Through this adaptive, individualized learning experience you can enhance your knowledge of risk factors for CMV infection specific to HCT recipients; update your understanding of recommendations for CMV prophylaxis, preemptive therapy (PET), and treatment of CMV disease in the HCT setting; learn about the emerging role of assessing cell-mediated immunity; enhance your clinical practices by applying clinical trial and real-world data from studies in HCT to your management strategies; and find out the benefits of multidisciplinary care for HCT recipients. 

What if you specialize in solid organ transplant (SOT)?

As with HCT, this adaptive, individualized learning experience provides comprehensive education and resources for SOT. Enhance your knowledge of risk factors for CMV infection specific to SOT recipients; update your understanding of recommendations for CMV prophylaxis, PET, and treatment of CMV disease in the SOT setting, with a focus on kidney transplant; learn about the emerging role of assessing cell-mediated immunity; enhance your clinical practices by applying clinical trial and real-world data from studies in SOT to your management strategies; and find out the benefits of multidisciplinary care for SOT recipients.

Are you a transplant pharmacist?

Transplant pharmacists play an integral role in the management of CMV in the transplant setting. Through this education program, you will be able to enhance your knowledge of the available antiviral agents for CMV prophylaxis, PET, and treatment of CMV disease; learn about the toxicity profiles and drug-drug interactions that need to be considered; find out how to optimize dosing of antiviral therapies for transplant recipients; and understand the vital role of pharmacists in antiviral stewardship initiatives.

Listen to our chair, Dr. Fernanda Silveira, as she shares the goals and topics of this unique activity.

PROGRAM DESCRIPTION

The role of the multidisciplinary transplant team, including transplant pharmacists, has expanded considerably over the past decade to keep pace with advances in the field and to address long-term care of transplant recipients. Despite these advances, breakthrough cytomegalovirus (CMV) infections and development of refractory and resistant CMV infections cause significant complications post-transplant. Transplant pharmacists can play a significant part in improving patient outcomes in multiple ways before, during, and after transplant including medication assessment and reconciliation, mitigating drug-drug interactions, dose optimization, antimicrobial stewardship, and ongoing patient education. To meet the needs of transplant pharmacists, this education offers personalized education with nuanced pathways applicable to solid organ and hematopoietic stem cell transplant (HSCT) settings. Learners will complete a brief assessment to inform targeted areas of educational need and then be able to build their own customized slide deck, allowing them to bypass areas of established knowledge and focus on areas of greatest interest or relevance to their clinical practice. 

INTENDED AUDIENCE

This activity is intended for healthcare providers who care for patients with cytomegalovirus (CMV) infection, solid organ and hematopoietic stem cell transplant specialists/surgeons, hematologists/oncologists, nephrologists, infectious disease specialists, transplant pharmacists, internal medicine and primary care physicians, nurses, and advanced practice providers (NPs/PAs).

ACTIVITY PURPOSE

Cytomegalovirus (CMV) infection is a serious complication with implications for morbidity and mortality in patients who have recently undergone solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT). Post-transplant CMV can cause tissue-invasive disease, including pneumonia, hepatitis, gastroenteritis, retinitis, and encephalitis, which can develop at various times (early and late) after the procedure. In addition, patients who develop a CMV infection ≥100 days after transplantation have been shown to have a 4.8-fold increased risk of death compared with those who do not develop late CMV. Advancements in prophylaxis and treatment have the potential to greatly improve outcomes but require patient monitoring and optimal treatment selection. This customized education program, developed for multidisciplinary teams, will provide clinicians involved in the management of transplant patients to with targeted interventions to address knowledge and competency gaps in CMV infection risks, prophylaxis, and treatment strategies.

LEARNING OBJECTIVES

Upon completion of this activity, pharmacists will be able to:

• Identify patients at risk for CMV infection following a solid organ or hematopoietic stem cell transplant
• Describe potential consequences and risk posed by CMV infection in post-transplant patients
• Review and discuss the latest evidence for the prophylaxis of patients at risk for CMV infection post-transplant
• Create effective prophylaxis regimens for patients at risk for CMV infection post-transplant
• Formulate individualized treatment plans for post-transplant patients with CMV infection who are refractory to treatment

AGENDA

• CMV infection in post-transplant patients
• Prophylaxis vs preemptive therapy (PET)
• Approved treatments for CMV infection
• Treatment strategies
• Roles of the MDT
• Future directions

FACULTY

Fernanda P. Silveira, MD, MS, FIDSA, FAST (Chair)
Professor of Medicine
Transplant Infectious Diseases Physician
Clinical Operations Director, Transplant Infectious Diseases
Division of Infectious Diseases
University of Pittsburgh and UPMC
Pittsburgh, PA

Roy F Chemaly, MD, MPH, FIDSA, FACP
Professor and Chair
G. P. Bodey, Sr. Distinguished Professorship in Infectious Diseases
Director, Clinical Virology Research
Department of Infectious Diseases, Infection Control, and Employee Health
University of Texas MD Anderson Cancer Center
Houston, TX

Raymund R. Razonable, MD
Professor of Medicine
Mayo Clinic College of Medicine and Science
Program Director, Mayo Clinic Infectious Diseases Fellowship Program
Mayo Clinic
Rochester, MN

FINANCIAL DISCLOSURE

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with all ineligible companies. All relevant financial relationships have been mitigated prior to this activity.

The following financial relationships have been provided:
Fernanda P. Silveira, MD, MS (Chair) 
Sources of Funding for Research/Grants: Ansun Biopharma, Inc., Glaxo Smith Kline, Merck & Co. Inc.
Consulting Agreements: Takeda
Advisory Board Member: Eurofins Viracor

Roy F Chemaly, MD, MPH, FIDSA, FACP
Advisor: ADMA Biologics, Inc., AiCuris, Ansun Biopharma, Moderna Therapeutics, Merck, Shionogi, Inc., Tether Therapeutics
Sources of Funding for Research/Grants: ADMA Biologics, Inc., AiCuris, Ansun Biopharma, Eurofins Viracor, LLC, Genetech, Karius, Moderna Therapeutics, Merck, Oxford Immunotec, Shionogi, Inc., Takeda, Tether Therapeutics   
Consulting Agreements: ADMA Biologics, Inc., AiCuris, Ansun Biopharma, Eurofins Viracor, LLC,  Karius, Moderna Therapeutics, Oxford Immunotec, Shionogi, Inc., Takeda, Tether Therapeutics  
Speakers' Bureau: Eurofins Viracor, LLC, Merck, Takeda

Raymund R. Razonable, MD
Sources of Funding for Research/Grant: Gilead, Regeneron, Roche
Advisory Board: AlloVir, Novartis

STAFF DISCLOSURES

ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

ACCREDITATION STATEMENTS

The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
This activity has been approved for 2.0 contact hours.

ACPE Universal Activity Number: 0396-0000-24-009-H01-P
Activity Type: Application

Method of Participation

To receive credit, learners are required to complete the assessment, view the online activity, and complete the posttest and evaluation. To receive credit, 80% must be achieved on the posttest. Your statement of participation will be made available immediately. Click on the View Statement of Participation link and print the statement for your records.  There is no fee to participate in the activity or for the generation of the certificate. Partial credit may not be awarded for CPE credit; participation in the complete activity is required to receive credit.

For questions, contact Karen Catino at kcatino@achlcme.org

Disclaimer

The content for this activity was developed independently of any ineligible company. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor(s).

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires the speaker to disclose that a product is not labeled for the use under discussion.

Discussion of scientific information on unapproved uses (SIUU), off-label, investigational, or experimental drug/device use: Valganciclovir, foscarnet, and cidofovir are not approved for the treatment of CMV infection/disease in HSCT; letermovir is not approved for the treatment of CMV disease and is not approved for CMV prophylaxis in solid organ transplant except kidney transplant; maribavir is not approved for prophylaxis or initial treatment of CMV infection/disease

COPYRIGHT STATEMENT

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