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)
- Enhanced activity at vaginal pH (4.5)
- Synergistic antifungal activity when combined with azoles or polyenes, particularly relevant for the treatment of invasive aspergillosis.