Maribavir is an orally active benzimidazole riboside antiviral agent. Maribavir competitively inhibits CMV pUL97 kinase activity (IC50=3nM). Maribavir blocks viral DNA replication, capsid formation, and nuclear egress. Maribavir retains activity against some traditional anti-CMV drug-resistant strains. Maribavir is used for refractory/resistant cytomegalovirus infection after transplantation and related research[1-4].
In vitro, human embryonic lung fibroblasts were treated with 0-100μM maribavir for 0-16 days. Maribavir inhibited cytomegalovirus replication yield measured by reporter gene SEAP expression[5]. MRC-5 cells infected with human cytomegalovirus were treated with 0.1-40μM maribavir for 24-96 hours. Maribavir reduced viral DNA accumulation and decreased viral titers[6]. Human foreskin fibroblasts were treated with 1-7μM maribavir for 6 days. Maribavir inhibited human cytomegalovirus AD169 strain replication[7].
In vivo, Sprague-Dawley rats were orally administered 0-400mg/kg/day Maribavir once daily for 1 month. Maribavir caused neutrophilia, increased lymphocyte, monocyte and total WBC counts, mild elevated bilirubin, increased absolute and relative adrenal, liver and spleen weights, and mild reversible intestinal mucosal hyperplasia[8].
References:[1] Levien TL, Baker DE. Maribavir. Hosp Pharm. 2023 Aug;58(4):336-344. doi: 10.1177/00185787221101480.
[2] Kang C. Maribavir: First Approval. Drugs. 2022 Feb;82(3):335-340.
[3] Sun K, Fournier M, Sundberg AK, et al. Maribavir: Mechanism of action, clinical, and translational science. Clin Transl Sci. 2024 Jan;17(1):e13696.
[4] Razonable RR. Current Perspectives on Letermovir and Maribavir for the Management of Cytomegalovirus Infection in Solid Organ Transplant Recipients. Drug Des Devel Ther. 2024 Sep 6;18:3987-4001.
[5] Chou S, Van Wechel L C, Marousek G I. Effect of cell culture conditions on the anticytomegalovirus activity of maribavir. Antimicrob Agents Chemother. 2006 Jul;50(7):2557-2559.
[6] Reitsma J, Terhune S, et al. Inhibition of cellular STAT3 synergizes with the cytomegalovirus kinase inhibitor maribavir to disrupt infection. Antiviral Res. 2014;104:74-85.
[7] Williams S L, Hartline C B, Kushner N L, et al. In vitro activities of benzimidazole D- and L-ribonucleosides against herpesviruses. Antimicrob Agents Chemother. 2003 Jul;47(7):2186-2192.
[8] Koszalka G W, Johnson N W, Good S S, et al. Preclinical and toxicology studies of 1263W94, a potent and selective inhibitor of human cytomegalovirus replication. Antimicrob Agents Chemother. 2002 Aug;46(8):2373-80.
















