Table 3 Overview of pharmacokinetic and pharmacodynamic parameters and dosing regimens of new antifungal agents
| Â | Rezafungin (CD101, Rezzayoâ„¢) | Ibrexafungerp (SCY-078, MK-3118) |
|---|---|---|
Class | Echinocandin (structural analog of anidulafungin) | Triterpenoid (Semi-synthetic derivative of enfumafungin) |
Indication | Treatment of candidemia and invasive candidiasis, in cases with limited or no alternative antifungal options | Treatment of vulvovaginal candidiasis |
Authorities’ approvals | EMA: 2022 FDA: 2023 | FDA: 2021 |
Recommended dosing regimen | LD 400 mg MD 200 mg weekly | LD 1000–1500 mg MD 500–750 mg daily |
Mode of administration | intravenous | oral |
Bioavailability | Not applicable | 35 to 50% |
Cmax (mg/L) | 11.8–19.2 | 0.43 |
AUC (mg*h/L) | 667–827 | 6.8 |
Vd (L/kg) | 0.95 | 8.5 |
Protein binding (%) | 87.5–93.6 | 99.5–99.8 |
Half-life (h) | 152 | 20–30 |
CL (mL/min) | 5.8 | 880 |
Candida spectrum | All Including C. auris (↓ for C. parapsilosis) | All Including C. auris (↓ for C. krusei, lusitaniae and guillermondi) |
PK/PD target | fAUC/MIC | fAUC/MIC |
Critically ill patients | No data | No data |
Critically ill patients with IAC | No data | No data |
Animal model with IAC | Faster, higher, and longer peritoneal diffusion | Excellent penetration in the liver |