Pharmacokinetic evaluation of ibrexafungerp for the treatment of vulvovaginal candidiasis and beyond

ABSTRACT

Introduction

Ibrexafungerp is a new triterpenoid antifungal agent with activity against a variety of fungal species, including Aspergillus spp. and echinocandin-resistant Candida spp.

Areas covered

This evaluation will summarize currently available clinical evidence on the use of ibrexafungerp in the treatment/prevention of vulvovaginal candidiasis (VVC) and detail the mechanism of action, pharmacokinetic/pharmacodynamic parameters, and ongoing/latest research involving ibrexafungerp.

Expert opinion

The evidence involving the utilization of ibrexafungerp for the treatment of VVC shows that it is superior when compared to placebo and has comparable clinical cure rates when compared with fluconazole. Ibrexafungerp demonstrates reliable coverage against several Candida spp. including echinocandin-resistant strains, Candida auris, and Aspergillus spp. For VVC, a dose of 300 mg (two 150 mg tablets) twice daily is recommended and does not require dose adjustments based on renal or hepatic function. The use of ibrexafungerp outside of VVC is currently under study with several ongoing trials showing promising interim data.

KEYWORDS:

• Candida
• VVC
• glucan synthase
• FKS
• terpenoid

Article highlights

• Ibrexafungerp is a novel triterpenoid antifungal with activity against several Candida spp., as well as Aspergillus spp.

• Oral ibrexafungerp provides safe and effective treatment for vulvovaginal candidiasis with minimal drug-drug interactions, does not require dose adjustments for age, sex, hepatic, or renal impairment, and has minimal adverse effects.

• Currently, oral ibrexafungerp is approved by the FDA for the treatment of vulvovaginal candidiasis and for the reduction in the incidence of recurrent vulvovaginal candidiasis and is currently being investigated for fungal infections outside of those indications.

• Ibrexafungerp does have activity against more resistant fungal organisms and offers another option for treating them.

• Ibrexafungerp is an effective treatment for vulvovaginal candidiasis and provides a potential role in transitioning to oral antifungal therapy.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.