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Ibrexafungerp: A Novel Oral Triterpenoid Antifungal in Development for the Treatment of <i>Candida auris</i> Infections

<i>Candida auris</i> is an emerging multidrug-resistant fungal pathogen reported worldwide. Infections due to <i>C. auris</i> are usually nosocomial and associated with high rates of fluconazole resistance and mortality. Echinocandins are utilized as the first-line treatment....

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Main Authors: Mahmoud Ghannoum (Author), Maiken Cavling Arendrup (Author), Vishnu P. Chaturvedi (Author), Shawn R. Lockhart (Author), Thomas S. McCormick (Author), Sudha Chaturvedi (Author), Elizabeth L. Berkow (Author), Deven Juneja (Author), Bansidhar Tarai (Author), Nkechi Azie (Author), David Angulo (Author), Thomas J. Walsh (Author)
Format: Book
Published: MDPI AG, 2020-08-01T00:00:00Z.
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Summary:<i>Candida auris</i> is an emerging multidrug-resistant fungal pathogen reported worldwide. Infections due to <i>C. auris</i> are usually nosocomial and associated with high rates of fluconazole resistance and mortality. Echinocandins are utilized as the first-line treatment. However, echinocandins are only available intravenously and are associated with increasingly higher rates of resistance by <i>C. auris</i>. Thus, a need exists for novel treatments that demonstrate potent activity against <i>C. auris</i>. Ibrexafungerp is a first-in-class triterpenoid antifungal agent. Similar to echinocandins, ibrexafungerp inhibits (1→3)-β-D-glucan synthase, a key component of the fungal cell wall, resulting in fungicidal activity against <i>Candida</i> spp. Ibrexafungerp demonstrates broad in vitro activity against various <i>Candida</i> spp. including <i>C. auris</i> and <i>C. auris</i> isolates with <i>fks</i> mutations. Minimum inhibitory concentration (MIC<sub>50</sub> and MIC<sub>90</sub>) values in >400 <i>C. auris</i> isolates were 0.5 μg/mL and 1.0 μg/mL, respectively. Clinical results were reported for two patients with invasive candidiasis or candidemia due to <i>C. auris</i> treated during the CARES (Candidiasis Caused by Candida Auris) trial, an ongoing open-label study. These patients experienced a complete response after treatment with ibrexafungerp. Thus, ibrexafungerp represents a promising new antifungal agent for treating <i>C. auris</i> infections.
Item Description:10.3390/antibiotics9090539
2079-6382

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