gms | German Medical Science

Frühjahrstagung der Sektion Antimykotische Chemotherapie 2013

Paul-Ehrlich-Gesellschaft für Chemotherapie (PEG e. V.)

12. - 13.04.2013, Bonn

New antifungal drugs – current status of clinical development

Meeting Abstract

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  • corresponding author Evgeny A. Idelevich - Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
  • author Andreas H. Groll - Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology/Oncology, University Children's Hospital, Münster , Germany

Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG). Frühjahrstagung der Sektion Antimykotische Chemotherapie 2013. Bonn, 12.-13.04.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13sac01

doi: 10.3205/13sac01, urn:nbn:de:0183-13sac013

Published: June 18, 2013

© 2013 Idelevich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



The approval of echinocandins and new azoles during the last decade caused a breakthrough in the therapy of fungal infections. Nevertheless, fungal pathogens, especially Candida spp., are becoming more resistant. Azole and echinocandin resistance rates are increasing worldwide. Furthermore, multidrug resistance, i.e., strains resistant to two or more classes of antifungal agents, are increasingly reported. Thus, new antifungals, particularly those with novel mechanisms of action, are urgently needed.

Currently, several candidates are in different phases of clinical development. Isavuconazole is an azole drug with an antifungal spectrum similar to that of voriconazole, but with longer plasma half-life. It is currently under development as oral and i.v. formulations in phase III studies of invasive candidiasis, invasive aspergillosis and rare mold infections. New formulations of posaconazole including aqueous solution for i.v. application based on β-cyclodextrin as solubilizer and a solid oral tablet with pH-sensitive polymer matrix and enhanced bioavailability have successfully passed phase I studies. New posaconazole formulations are appreciated given the variable pharmacokinetics of the approved oral suspension, mainly due to absorption issues. MK-3118 (enfumafungin derivative), an oral glucan synthase inhibitor with in vitro and in vivo activity against Candida and Aspergillus species, has been successful in phase I. MGCD290 is an oral small molecule which targets the Hos2 fungal enzyme and, thus, potentiates and broadens the activity of azoles, especially fluconazole. MGCD290 has entered phase II with indication of vulvovaginal candidiasis. Other molecules are yet in the preclinical development, e.g., a second generation echinocandin ASP9726 with enhanced activity against Aspergillus spp.

Maximum efforts should be made by industry, academia and government to avoid the gap in the clinical development of antifungals that is currently observed with antibacterial drugs.