학술논문

Invasive candidiasis: investigational drugs in the clinical development pipeline and mechanisms of action
Document Type
article
Source
Expert Opinion on Investigational Drugs. 31(8)
Subject
Medical Microbiology
Biomedical and Clinical Sciences
Clinical Sciences
Antimicrobial Resistance
Infectious Diseases
Prevention
5.1 Pharmaceuticals
Development of treatments and therapeutic interventions
Infection
Antifungal Agents
Candida
Candidiasis
Candidiasis
Invasive
Drug Resistance
Fungal
Drugs
Investigational
Humans
Microbial Sensitivity Tests
Antimycotic
antiinfective
resistance
activity
trials
APX001
CD101
SCY-078
manogepix
fosmanogepix
ibrexafungerp
rezafungin
MAT2203
oteseconazole
VT-1161
ATI-2307
VL-2397
NP-339
miltefosine
Pharmacology and Pharmaceutical Sciences
Pharmacology & Pharmacy
Oncology and carcinogenesis
Pharmacology and pharmaceutical sciences
Language
Abstract
IntroductionThe epidemiology of invasive Candida infections is evolving. Infections caused by non-albicans Candida spp. are increasing; however, the antifungal pipeline is more promising than ever and is enriched with repurposed drugs and agents that have new mechanisms of action. Despite progress, unmet needs in the treatment of invasive candidiasis remain, and there are still too few antifungals that can be administered orally or that have CNS penetration.Areas coveredThe authors shed light on those antifungal agents active against Candida that are in early- and late-stage clinical development. Mechanisms of action and key pharmacokinetic and pharmacodynamic properties are discussed. Insights are offered on the potential future roles of the investigational agents MAT-2203, oteseconazole, ATI-2307, VL-2397, NP-339, and the repurposed drug miltefosine.Expert opinionIbrexafungerp and fosmanogepix have novel mechanisms of action and will provide effective options for the treatment of Candida infections (including those caused by multiresistant Candida spp). Rezafungin, an echinocandin with an extended half-life allowing for once weekly administration, will be particularly valuable for outpatient treatment and prophylaxis. Despite this, there is an urgent need to garner clinical data on investigational drugs, especially in the current rise of azole-resistant and multidrug-resistant Candida spp.