科研之友
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摘要
Objectives. - Despite the avaibility of several new antifungal drugs, the morbidity of fungal infections remains high. Therefore, search of new drugs is spurred either in already known classes such as triazoles and echinocandins, to improve safety and pharmacokinetic profile, or in new class of antifungal drugs. <br xmlns:set="http://exslt.org/sets">Improvement in triazoles. - Among the triazoles, isavuconazole has a wide spectrum of activity, a long hatf-life, a Large volume of distribution, and numerous in vitro data supporting its efficacy in invasive aspergillosis and candidiasis. Phase 3 studies are in progress. Albaconazole has very potent activity against species of Candida, Cryptococcus and Aspergillus although additional comparative studies with other azoles are necessary. Nevertheless, these new azoles keep some degrees of drug interactions and cross-resistance between azoles. Place of echinocandines. - Aminocandin, as the other echinocandins, has no oral route and its spectrum is restricted to species of Candida and Aspergillus. Aminocandin has an extended half live, with a possible administration rhythm below one injection a day. New classes: FG34091, 1(st) studies. - Among the new classes of antifungal drugs, FG3409, a "small molecule", has been investigated. FG3409 has a wide spectrum, including species and isolates resistant to azoles or amphotericin B. Pharmacological studies in vitro and in animal models show a good safety and an efficacy in the same range as itraconazole and caspofungin. FG3409 has a good pharmacokinetic profile, with both oral and i.v. routes available, and few drug interactions. Another strategy is the concomitant use of human monoclonal antibody against Heat Shock Protein 90 (HSP90) and liposomal amphotericin B. Despite a promising clinical trial, development on this strategy seems to slow down.
- 出版日期2009-9
