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Ibrexafungerp: A novel antifungal

Ibrexafungerp is the first representative of a novel class of structurally-distinct glucan synthase inhibitors, triterpenoids.

It has broad spectrum activity encompassing Candida, Aspergillus, Pneumocystis, Dimorphic fungi and mucorales, including multi-drug resistant (MDR) species and pan resistant species such as Candida auris. Ibrexafungerp combines the well-established activity of glucan synthase inhibitors with the flexibility of oral and IV formulations, offering a broad use across different settings (in-patient and out-patient).

Ibrexafungerp has the potential to be an essential therapy in the treatment of multiple serious fungal infections:

  • Novel glucan synthase inhibitor
  • Potent activity against most common fungi pathogens, including those resistant to other antifungals

Highlights

  • Broad spectrum (including multidrug-resistant strains)

    Fungicidal vs. Candida

  • Convenient oral dosing

  • High tissue penetration

    High concentrations in tissues of interest, except CNS

  • Favorable safety profile and well tolerated

    ~2,000 subjects exposed
    Low risk of drug-drug interactions

  • Worldwide rights and long exclusivity (patent protection up to 2035)

    Qualified Infectious Disease Product (QIDP), Fast Track and Orphan Drug status for invasive candidiasis and aspergillosis

Ibrexafungerp is an investigational drug. Items listed above illustrate ibrexafungerp target attributes.

How does ibrexafungerp work?

Ibrexafungerp is a glucan synthase inhibitor and operates via a validated mechanism of action (MOA) that inhibits the enzyme responsible for the synthesis of β-(1,3)-glucan:

  • Inhibition of the synthesis of β-(1,3)-D-glucan, an essential component of the fungal cell wall of many pathogenic fungi, results in cytological and ultrastructural changes in the fungi compromising their ability to survive
  • The cell wall of fungi is a unique target not encountered in mammalian cells, which provides for the good safety profile of ibrexafungerp and other glucan synthase inhibitors (limited risk for “off-target” effect, such as human cell toxicity)
  • The MOA (glucan synthase inhibition) has been previously validated as a clinically relevant target by the echinocandins
  • Due to the different structure and enzyme-inhibition properties, ibrexafungerp retains activity against the majority of echinocandin-resistant strains
  • Disruption of the fungal cell wall is fungicidal against Candida spp
  • No cross-resistance with azoles because of the different MOA

How is ibrexafungerp different?

The structure of ibrexafungerp (formerly SCY-078) and echinocandins are very different, allowing for:

  • Different enzyme-inhibition properties than the echinocandins
  • Most gene mutations (FKS) that confer resistance to echinocandins do not affect the activity of ibrexafungerp
  • Administration orally and IV (echinocandins are only available IV)
  • Extensive distribution into key tissues associated with fungal infections, often achieving tissue concentration severalfold above the plasma concentrations (echinocandins have a limited tissue distribution achieving tissue concentration at or below plasma concentrations)

The MOA of ibrexafungerp is different from the azoles and polyenes, allowing for:

  • Retention of activity against azole and polyene-resistant strains
  • Potential for more favorable safety profile
  • Lower risk for drug-drug interaction (vs. azoles)
  • Retained activity at vaginal pH (4.5)
  • Synergistic antifungal activity when combined with azoles or polyenes, particularly relevant for the treatment of invasive aspergillosis

Clinical Trials

Ongoing

Furi

Open-Label Study to Evaluate the Efficacy and Safety of Ibrexafungerp in Patients with Refractory or Intolerant Fungal Diseases.
Cares

Open-Label Study to Evaluate the Efficacy and Safety of Ibrexafungerp in Patients with Candidiasis Caused by Candida Auris.
Scynergia

A Phase 2 multicenter, Randomized, Double-Blind Study to Evaluate the Safety and Efficacy of the Coadministration of ibrexafungerp with voriconazole in Patients with Invasive Pulmonary Aspergillosis.
Mario

Global Phase 3 study to evaluate the efficacy, safety and tolerability of oral ibrexafungerp as a step-down therapy from an intravenous (IV) echinocandin in patients with invasive candidiasis (IC), including candidemia, a Candida infection in the blood.
Vanquish

Phase 3b, open-label, multicenter study to evaluate the efficacy, safety and tolerability of oral ibrexafungerp as a treatment for complicated vulvovaginal candidiasis (VVC) in patients who have failed treatment with fluconazole, based on mycological and clinical outcomes.

Completed

Vanish 303 & 306

Ibrexafungerp for Vulvovaginal Candidiasis (VVC)
Candle

Ibrexafungerp for Recurrent Vulvovaginal Candidiasis (RVVC)

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Our Data

SCYNEXIS regularly presents key infectious disease study data at top medical meetings.

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