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Therapeutics and Clinical Risk Management

Therapeutics and Clinical Risk Management

IF: 2.79
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Role of isavuconazole in the treatment of invasive fungal infections.

Published:3 August 2016 DOI: 10.2147/TCRM.S90335 PMID: 27536124
Dustin T Wilson, V Paul Dimondi, Steven W Johnson, Travis M Jones, Richard H Drew

Abstract

Despite recent advances in both diagnosis and prevention, the incidence of invasive fungal infections continues to rise. Available antifungal agents to treat invasive fungal infections include polyenes, triazoles, and echinocandins. Unfortunately, individual agents within each class may be limited by spectrum of activity, resistance, lack of oral formulations, significant adverse event profiles, substantial drug-drug interactions, and/or variable pharmacokinetic profiles. Isavuconazole, a second-generation triazole, was approved by the US Food and Drug Administration in March 2015 and the European Medicines Agency in July 2015 for the treatment of adults with invasive aspergillosis (IA) or mucormycosis. Similar to amphotericin B and posaconazole, isavuconazole exhibits a broad spectrum of in vitro activity against yeasts, dimorphic fungi, and molds. Isavuconazole is available in both oral and intravenous formulations, exhibits a favorable safety profile (notably the absence of QTc prolongation), and reduced drug-drug interactions (relative to voriconazole). Phase 3 studies have evaluated the efficacy of isavuconazole in the management of IA, mucormycosis, and invasive candidiasis. Based on the results of these studies, isavuconazole appears to be a viable treatment option for patients with IA as well as those patients with mucormycosis who are not able to tolerate or fail amphotericin B or posaconazole therapy. In contrast, evidence of isavuconazole for invasive candidiasis (relative to comparator agents such as echinocandins) is not as robust. Therefore, isavuconazole use for invasive candidiasis may initially be reserved as a step-down oral option in those patients who cannot receive other azoles due to tolerability or spectrum of activity limitations. Post-marketing surveillance of isavuconazole will be important to better understand the safety and efficacy of this agent, as well as to better define the need for isavuconazole serum concentration monitoring.

Substances (4)

Related products
Procduct Name CAS Molecular Formula Supplier Price
Amphotericin B 1397-89-3 C47H73NO17 790 suppliers $7.00-$29840.00
Posaconazole 171228-49-2 C37H42F2N8O4 783 suppliers $6.00-$2691.10
Voriconazole 137234-62-9 C16H14F3N5O 750 suppliers $9.00-$3330.75
Isavuconazole 241479-67-4 C22H17F2N5OS 377 suppliers $8.00-$5857.00

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