10 results on '"Marty, Francisco"'
Search Results
2. A Breath Fungal Secondary Metabolite Signature to Diagnose Invasive Aspergillosis
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Koo, Sophia, Thomas, Horatio R., Daniels, S. David, Lynch, Robert C., Fortier, Sean M., Shea, Margaret M., Rearden, Preshious, Comolli, James C., Baden, Lindsey R., and Marty, Francisco M.
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- 2014
3. Maribavir for Refractory Cytomegalovirus Infections With or Without Resistance Post-Transplant: Results From a Phase 3 Randomized Clinical Trial.
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Avery, Robin K, Alain, Sophie, Alexander, Barbara D, Blumberg, Emily A, Chemaly, Roy F, Cordonnier, Catherine, Duarte, Rafael F, Florescu, Diana F, Kamar, Nassim, Kumar, Deepali, Maertens, Johan, Marty, Francisco M, Papanicolaou, Genovefa A, Silveira, Fernanda P, Witzke, Oliver, Wu, Jingyang, Sundberg, Aimee K, Fournier, Martha, and Investigators, SOLSTICE Trial
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CONFIDENCE intervals ,CYTOMEGALOVIRUS diseases ,ANTIVIRAL agents ,PATIENTS ,TREATMENT effectiveness ,RANDOMIZED controlled trials ,PRE-tests & post-tests ,COMPARATIVE studies ,DESCRIPTIVE statistics ,DRUG resistance in microorganisms ,STATISTICAL sampling ,TRANSPLANTATION of organs, tissues, etc. - Abstract
Background Therapies for refractory cytomegalovirus infections (with or without resistance [R/R]) in transplant recipients are limited by toxicities. Maribavir has multimodal anti-cytomegalovirus activity through the inhibition of UL97 protein kinase. Methods In this phase 3, open-label study, hematopoietic-cell and solid-organ transplant recipients with R/R cytomegalovirus were randomized 2:1 to maribavir 400 mg twice daily or investigator-assigned therapy (IAT; valganciclovir/ganciclovir, foscarnet, or cidofovir) for 8 weeks, with 12 weeks of follow-up. The primary endpoint was confirmed cytomegalovirus clearance at end of week 8. The key secondary endpoint was achievement of cytomegalovirus clearance and symptom control at end of week 8, maintained through week 16. Results 352 patients were randomized (235 maribavir; 117 IAT). Significantly more patients in the maribavir versus IAT group achieved the primary endpoint (55.7% vs 23.9%; adjusted difference [95% confidence interval (CI)]: 32.8% [22.80–42.74]; P < .001) and key secondary endpoint (18.7% vs 10.3%; adjusted difference [95% CI]: 9.5% [2.02–16.88]; P = .01). Rates of treatment-emergent adverse events (TEAEs) were similar between groups (maribavir, 97.4%; IAT, 91.4%). Maribavir was associated with less acute kidney injury versus foscarnet (8.5% vs 21.3%) and neutropenia versus valganciclovir/ganciclovir (9.4% vs 33.9%). Fewer patients discontinued treatment due to TEAEs with maribavir (13.2%) than IAT (31.9%). One patient per group had fatal treatment-related TEAEs. Conclusions Maribavir was superior to IAT for cytomegalovirus viremia clearance and viremia clearance plus symptom control maintained post-therapy in transplant recipients with R/R cytomegalovirus. Maribavir had fewer treatment discontinuations due to TEAEs than IAT. Clinical Trials Registration. NCT02931539 (SOLSTICE). [ABSTRACT FROM AUTHOR]
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- 2022
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4. Isavuconazole Treatment of Invasive Fungal Sinusitis: A Post Hoc Analysis of the SECURE and VITAL Trials.
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Durand, Marlene L, Kitt, Therese M, Song, Yi, and Marty, Francisco M
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ANTIFUNGAL agents ,STATISTICS ,IMMUNOCOMPROMISED patients ,TIME ,DIABETES ,ASPERGILLOSIS ,TREATMENT effectiveness ,SINUSITIS ,MYCOSES ,SURVIVAL analysis (Biometry) ,DATA analysis ,SALVAGE therapy - Abstract
This post hoc analysis of international phase III isavuconazole trials identified 50 patients (90% immunocompromised or diabetic) with invasive fungal sinusitis (88% mucormycetes, Aspergillus) who received isavuconazole as primary (n = 33) or salvage (n = 17) therapy for a median of 82 days (range, 2–882). Overall survival was 82% at day 42 and 70% at day 84. [ABSTRACT FROM AUTHOR]
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- 2021
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5. DAS181 Treatment of Severe Lower Respiratory Tract Parainfluenza Virus Infection in Immunocompromised Patients: A Phase 2 Randomized, Placebo-Controlled Study.
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Chemaly, Roy F, Marty, Francisco M, Wolfe, Cameron R, Lawrence, Steven J, Dadwal, Sanjeet, Soave, Rosemary, Farthing, Jason, Hawley, Stephen, Montanez, Paul, Hwang, Jimmy, Ho, Jennifer Hui-Chun, Lewis, Stanley, Wang, George, and Boeckh, Michael
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STATISTICS , *RNA virus infections , *IMMUNOCOMPROMISED patients , *ANTIVIRAL agents , *RESPIRATORY infections , *HEALTH outcome assessment , *RANDOMIZED controlled trials , *PLACEBOS , *ARTIFICIAL respiration , *COMPARATIVE studies , *INFLUENZA , *SURVIVAL analysis (Biometry) , *DESCRIPTIVE statistics , *STATISTICAL sampling , *DATA analysis , *RECOMBINANT proteins - Abstract
Background There are no antiviral therapies for parainfluenza virus (PIV) infections. DAS181, a sialidase fusion protein, has demonstrated activity in in vitro and in animal models of PIV. Methods Adult immunocompromised patients diagnosed with PIV lower respiratory tract infection (LRTI) who required oxygen supplementation were randomized 2:1 to nebulized DAS181 (4.5 mg/day) or matching placebo for up to 10 days. Randomization was stratified by need for mechanical ventilation (MV) or supplemental oxygen (SO). The primary endpoint was the proportion of patients reaching clinical stability survival (CSS) defined as returning to room air (RTRA), normalization of vital signs for at least 24 hours, and survival up to day 45 from enrollment. Results A total of 111 patients were randomized to DAS181 (n = 74) or placebo (n = 37). CSS was achieved by 45.0% DAS181-treated patients in the SO stratum compared with 31.0% for placebo (P =.15), whereas patients on MV had no benefit from DAS181. The proportion of patients achieving RTRA was numerically higher for SO stratum DAS181 patients (51.7%) compared with placebo (34.5%) at day 28 (P =.17). In a post hoc analysis of solid organ transplant, hematopoietic cell transplantation within 1 year, or chemotherapy within 1 year, more SO stratum patients achieved RTRA on DAS181 (51.8%) compared with placebo (15.8%) by day 28 (P =.012). Conclusions The primary endpoint was not met, but post hoc analysis of the RTRA component suggests DAS181 may have clinical activity in improving oxygenation in select severely immunocompromised patients with PIV LRTI who are not on mechanical ventilation. Clinical Trials Registration. NCT01644877. [ABSTRACT FROM AUTHOR]
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- 2021
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6. A Phase 2b, Randomized, Double-blind, Placebo-Controlled Multicenter Study Evaluating Antiviral Effects, Pharmacokinetics, Safety, and Tolerability of Presatovir in Hematopoietic Cell Transplant Recipients with Respiratory Syncytial Virus Infection of the Lower Respiratory Tract
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Marty, Francisco M, Chemaly, Roy F, Mullane, Kathleen M, Lee, Dong-Gun, Hirsch, Hans H, Small, Catherine B, Bergeron, Anne, Shoham, Shmuel, Ljungman, Per, Waghmare, Alpana, Blanchard, Elodie, Kim, Yae-Jean, McKevitt, Matt, Porter, Danielle P, Jordan, Robert, Guo, Ying, German, Polina, Boeckh, Michael, Watkins, Timothy R, and Chien, Jason W
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ANTIVIRAL agents , *CONFIDENCE intervals , *HEMATOPOIETIC stem cell transplantation , *MEDICAL cooperation , *PATIENT safety , *RESEARCH , *RESPIRATORY infections , *TRANSPLANTATION of organs, tissues, etc. , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *BLIND experiment , *DATA analysis software , *DESCRIPTIVE statistics , *RESPIRATORY syncytial virus infections , *PHARMACODYNAMICS - Abstract
Background Presatovir significantly reduced nasal viral load, signs, and symptoms of respiratory syncytial virus (RSV) infection in a human challenge study. We evaluated presatovir in hematopoietic-cell transplant (HCT) recipients with RSV lower respiratory tract infection (LRTI). Methods Patients with confirmed RSV in upper and lower respiratory tract and new chest X-ray abnormalities were randomized (1:1), stratified by supplemental oxygen and ribavirin use, to receive oral presatovir 200 mg or placebo every 4 days for 5 doses. The primary endpoint was time-weighted average change in nasal RSV viral load through day 9. Secondary endpoints included supplemental oxygen-free days, incident respiratory failure requiring mechanical ventilation, and all-cause mortality. Results From January 31, 2015, to March 20, 2017, 60 patients from 17 centers were randomized (31 presatovir, 29 placebo); 59 received study treatment (50 allogeneic, 9 autologous HCT). In the efficacy population (29 presatovir, 28 placebo), presatovir treatment did not significantly reduce time-weighted average change in viral load (−1.12 vs −1.09 log10 copies/mL; treatment difference −0.02 log10 copies/mL, 95% confidence interval: −.62,.57; P =.94), median supplemental oxygen-free days (26 vs 28 days, P =.84), incident respiratory failure (10.3 vs 10.7%, P =.98), or all-cause mortality (0 vs 7.1%, P =.19) versus placebo. Adverse events were similar between arms (presatovir 80%, placebo 79%). Resistance-associated substitutions in RSV fusion protein emerged in 6/29 presatovir-treated patients. Conclusions Presatovir treatment was well tolerated in HCT patients with RSV LRTI but did not improve virologic or clinical outcomes versus placebo. Clinical Trials Registration www.clinicaltrials.gov , NCT02254421; EudraCT, #2014-002475-29 [ABSTRACT FROM AUTHOR]
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- 2020
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7. Long-term Persistence of an Extensively Drug-Resistant Subclade of Globally Distributed Pseudomonas aeruginosa Clonal Complex 446 in an Academic Medical Center.
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Pincus, Nathan B, Bachta, Kelly E R, Ozer, Egon A, Allen, Jonathan P, Pura, Olivia N, Qi, Chao, Rhodes, Nathaniel J, Marty, Francisco M, Pandit, Alisha, Mekalanos, John J, Oliver, Antonio, and Hauser, Alan R
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ACADEMIC medical centers ,DRUG resistance in microorganisms ,MICROBIAL sensitivity tests ,MULTIDRUG resistance ,PHYLOGENY ,PSEUDOMONAS diseases ,SEQUENCE analysis - Abstract
Background Antimicrobial resistance (AMR) is a major challenge in the treatment of infections caused by Pseudomonas aeruginosa. Highly drug-resistant infections are disproportionally caused by a small subset of globally distributed P. aeruginosa sequence types (STs), termed "high-risk clones." We noted that clonal complex (CC) 446 (which includes STs 298 and 446) isolates were repeatedly cultured at 1 medical center and asked whether this lineage might constitute an emerging high-risk clone. Methods We searched P. aeruginosa genomes from collections available from several institutions and from a public database for the presence of CC446 isolates. We determined antibacterial susceptibility using microbroth dilution and examined genome sequences to characterize the population structure of CC446 and investigate the genetic basis of AMR. Results CC446 was globally distributed over 5 continents. CC446 isolates demonstrated high rates of AMR, with 51.9% (28/54) being multidrug-resistant (MDR) and 53.6% of these (15/28) being extensively drug-resistant (XDR). Phylogenetic analysis revealed that most MDR/XDR isolates belonged to a subclade of ST298 (designated ST298*) of which 100% (21/21) were MDR and 61.9% (13/21) were XDR. XDR ST298* was identified repeatedly and consistently at a single academic medical center from 2001 through 2017. These isolates harbored a large plasmid that carries a novel antibiotic resistance integron. Conclusions CC446 isolates are globally distributed with multiple occurrences of high AMR. The subclade ST298* is responsible for a prolonged epidemic (≥16 years) of XDR infections at an academic medical center. These findings indicate that CC446 is an emerging high-risk clone deserving further surveillance. [ABSTRACT FROM AUTHOR]
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- 2020
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8. A Mortality Analysis of Letermovir Prophylaxis for Cytomegalovirus (CMV) in CMV-seropositive Recipients of Allogeneic Hematopoietic Cell Transplantation.
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Ljungman, Per, Schmitt, Michael, Marty, Francisco M, Maertens, Johan, Chemaly, Roy F, Kartsonis, Nicholas A, Butterton, Joan R, Wan, Hong, Teal, Valerie L, Sarratt, Kendra, Murata, Yoshihiko, Leavitt, Randi Y, and Badshah, Cyrus
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ANTIVIRAL agents ,CYTOMEGALOVIRUS diseases ,HEMATOPOIETIC stem cell transplantation ,RISK assessment ,STATISTICAL sampling ,STATISTICS ,TRANSPLANTATION of organs, tissues, etc. ,DATA analysis ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,DISEASE incidence ,PROPORTIONAL hazards models ,DESCRIPTIVE statistics ,KAPLAN-Meier estimator ,PHARMACODYNAMICS - Abstract
Background In a phase 3 trial, letermovir reduced clinically significant cytomegalovirus infections (CS-CMVi) and all-cause mortality at week 24 versus placebo in CMV-seropositive allogeneic hematopoietic cell transplantation (HCT) recipients. This post hoc analysis of phase 3 data further investigated the effects of letermovir on all-cause mortality. Methods Kaplan-Meier survival curves were generated by treatment group for all-cause mortality. Observations were censored at trial discontinuation for reasons other than death or at trial completion. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox modeling, adjusting for risk factors associated with mortality. Results Of 495 patients with no detectable CMV DNA at randomization, 437 had vital-status data available through week 48 post-HCT at trial completion (101 deaths, 20.4%). Following letermovir prophylaxis, the HR for all-cause mortality was 0.58 (95% CI, 0.35–0.98; P =.04) at week 24 and 0.74 (95% CI, 0.49–1.11; P =.14) at week 48 post-HCT versus placebo. Incidence of all-cause mortality through week 48 post-HCT in the letermovir group was similar in patients with or without CS-CMVi (15.8 vs 19.4%; P =.71). However, in the placebo group, all-cause mortality at week 48 post-HCT was higher in patients with versus those without CS-CMVi (31.0% vs 18.2%; P =.02). The HR for all-cause mortality in patients with CS-CMVi was 0.45 (95% CI, 0.21–1.00; P =.05) at week 48 for letermovir versus placebo. Conclusions Letermovir may reduce mortality by preventing or delaying CS-CMVi in HCT recipients. Clinical Trials Registration clinicaltrials.gov, NCT02137772. [ABSTRACT FROM AUTHOR]
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- 2020
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9. Risk of Latent Tuberculosis Reactivation After Hematopoietic cell Transplantation.
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Cheng, Matthew P, Kusztos, Amanda E, Bold, Tyler D, Ho, Vincent T, Glotzbecker, Brett E, Hsieh, Candace, Baker, Meghan A, Baden, Lindsey R, Hammond, Sarah P, and Marty, Francisco M
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TUBERCULOSIS prevention ,TUBERCULOSIS risk factors ,CONFIDENCE intervals ,DRUG prescribing ,HEMATOPOIETIC stem cell transplantation ,PATIENT aftercare ,LONGITUDINAL method ,PREVENTIVE health services ,RISK assessment ,TRANSPLANTATION of organs, tissues, etc. ,PHYSICIAN practice patterns - Abstract
There were no cases of tuberculosis in a cohort of 2531 patients who underwent hematopoietic cell transplantation from 2010 to 2015 after 7323 person-years of follow up (95% confidence interval [CI], 0.0–0.05 cases/100 person-years), including 29 (1.15%) patients with untreated latent tuberculosis after 89 person-years of follow-up (95% CI, 0.0–4.06 cases/100 person-years). [ABSTRACT FROM AUTHOR]
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- 2019
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10. Maribavir for Refractory or Resistant Cytomegalovirus Infections in Hematopoietic-cell or Solid-organ Transplant Recipients: A Randomized, Dose-ranging, Double-blind, Phase 2 Study.
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Papanicolaou, Genovefa A, Silveira, Fernanda P, Langston, Amelia A, Pereira, Marcus R, Avery, Robin K, Uknis, Marc, Wijatyk, Anna, Wu, Jingyang, Boeckh, Michael, Marty, Francisco M, and Villano, Stephen
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ANTIVIRAL agents ,CYTOMEGALOVIRUS diseases ,DNA ,DRUG resistance ,HEMATOPOIETIC stem cell transplantation ,GENETIC mutation ,NEUTROPHILS ,NUCLEOSIDES ,TASTE disorders ,TIME ,TRANSPLANTATION of organs, tissues, etc. ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,ADVERSE health care events ,DESCRIPTIVE statistics ,THERAPEUTICS - Abstract
Background Cytomegalovirus (CMV) infections that are refractory or resistant (RR) to available antivirals ([val]ganciclovir, foscarnet, cidofovir) are associated with higher mortality in transplant patients. Maribavir is active against RR CMV strains. Methods Hematopoietic-cell or solid-organ transplant recipients ≥12 years old with RR CMV infections and plasma CMV deoxyribonucleic acid (DNA) ≥1000 copies/mL were randomized (1:1:1) to twice-daily dose-blinded maribavir 400, 800, or 1200 mg for up to 24 weeks. The primary efficacy endpoint was the proportion of patients with confirmed undetectable plasma CMV DNA within 6 weeks of treatment. Safety analyses included the frequency and severity of treatment-emergent adverse events (TEAEs). Results From July 2012 to December 2014, 120 patients were randomized and treated (40 per dose group): 80/120 (67%) patients achieved undetectable CMV DNA within 6 weeks of treatment (95% confidence interval, 57–75%), with rates of 70%, 63%, and 68%, respectively, for maribavir 400, 800, and 1200 mg twice daily. Recurrent on-treatment CMV infections occurred in 25 patients; 13 developed mutations conferring maribavir resistance. Maribavir was discontinued due to adverse events in 41/120 (34%) patients, and 17/41 discontinued due to CMV infections. During the study, 32 (27%) patients died, 4 due to CMV disease. Dysgeusia was the most common TEAE (78/120; 65%) and led to maribavir discontinuation in 1 patient. Absolute neutrophil counts <1000/µL were noted in 12/106 (11%) evaluable patients, with rates similar across doses. Conclusions Maribavir ≥400 mg twice daily was active against RR CMV infections in transplant recipients; no new safety signals were identified. Clinical Trials Registration NCT01611974. [ABSTRACT FROM AUTHOR]
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- 2019
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