■在过去的二十年里,鉴于抗性真菌的出现,我们经历了对抗真菌药库新添加的迫切需求,侵袭性真菌病(IFD)高危患者人群的增长,与IFD相关的高发病率和死亡率。涵盖的领域:当前的审查将讨论用于IFD的五种有前途的抗真菌药物(即fosmanogepix,Ibrexafungerp,olorofim,rezafungin和opelconazole),现在在晚期临床研究中,并且可能在不久的将来可用于临床。对于每个特工来说,我们描述了它的作用机制,药代动力学和药效学特性,活动谱以及安全性和有效性数据,包括正在进行的临床试验的结果。还将讨论这些新型抗真菌药物在临床实践中的潜在作用以及临床使用的关键考虑因素。
■这些新型药物的需求尚未满足,应在未来的研究中解决。这些包括定义他们的适应症和益处,如何最好地适当地瞄准他们,监视和管理他们的使用。
Over the last two decades, we have experienced pressing needs for new additions to the antifungal armamentarium given the emergence of resistant fungi, the growth of at-risk patient populations for invasive fungal diseases (IFD), the high morbidity and mortality associated with IFD.
The current review will discuss the five promising antifungal agents for IFD (i.e. fosmanogepix, ibrexafungerp, olorofim, rezafungin, and opelconazole), now in the late-phase clinical studies, and likely to be available for clinical use in the near future. For each agent, we describe its mechanism of action, pharmacokinetic and pharmacodynamic properties, spectrum of activity as well as the safety and efficacy data, including findings from ongoing clinical trials. The potential roles of these novel antifungals in clinical practice and the key considerations for clinical use will also be discussed.
There are unmet needs of these novel agents that should be addressed in the future studies. These include defining their indications and benefits, how to best target them appropriately, surveillance and stewardship of their use.