title: Isavuconazole: a new extended spectrum triazole for invasive mold diseases.
abstract: Isavuconazole is the first broad spectrum prodrug triazole with efficacy against invasive fungal diseases including aspergillosis and mucormycosis. Characteristics include linear dose-proportional pharmacokinetics, intravenous and oral formulations allowing therapeutic streamlining, once daily dosing, absence of nephrotoxic solubilizing agents and excellent oral bioavailability independent of prandial status and gastric acidity. An open label noncomparator study demonstrated encouraging results for isavuconazole as primary or salvage therapy for a range of fungi including mucormycosis. Isavuconazole had fewer premature drug discontinuations and adverse events in the eye, hepatobiliary and psychiatry systems than the comparator agent, voriconazole in a randomized double-blind clinical trial. Cross-resistance of isavuconazole best correlates with voriconazole. In vitro resistance is not invariably predictive of clinical failure. Isavuconazole signals progress in pharmacokinetics, bioavailability and toxicity/tolerability supported by clinical efficacy from Phase III trials.
authors.affiliation: 1Infectious Diseases Unit, Alfred Health, Melbourne, VIC, Australia.
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Ananda-Rajah
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kontoyiannis
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005658:Fungi / Q000187:drug effects*; D006801:Humans; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology*; D009570:Nitriles / Q000009:adverse effects / Q000627:therapeutic use*; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014230:Triazoles / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000935:Antifungal Agents; D009570:Nitriles; D011725:Pyridines; D014230:Triazoles; C508735:isavuconazole
keywords: invasive aspergillosis; invasive fungal infections; isavuconazole; mucormycosis