FURI Study Case: Ibrexafungerp Successfully Treats Esophageal Candidiasis
APR 13, 2019 | MICHAELA FLEMING
Candida species are a common cause of mucosal and invasive candidiasis. In certain circumstances, patients may develop refractory candidiasis as a result of either resistance to antifungals or innate immune system deficiencies.
While conducting a study evaluating the safety and efficacyofibrexafungerp (IBX, formerly SCY-078), investigators observed that a case of severe refractory esophageal candidiasis was treated successfully with the novel glucan synthase inhibitor antifungal.
Details on this case were presented in a poster presentation at the European Congress for Clinical Microbiology and Infectious Diseases (ECCMID 2019).
IBX has documented broad spectrum of activity against common species of Candida, Aspergillus, and Pneumocystis. The antifungal is being evaluated in an open-label clinical trial of patients either intolerant or refractory to antifungal therapy. The trial is called SCYNEXIS Study 301, or FURI.
At ECCMID 2019, Contagion® spoke to the presenter of the poster Jose Vazquez, MD, chief of infectious disease at Medical College of Georgia, who is also a member of the Contagion® Editorial Advisory Board.
One patient, a 63-year-old man with esophageal candidiasis that was refractory to fluconazole 200 mg/daily was enrolled into the trial. The patient had a history of esophageal strictures with recurrent esophageal candidiasis documented in the past 10 years.
Prior to enrollment, the patient experienced dysphagia, which escalated to the point that he was unable to swallow. As a result, a feeding tube was inserted. Additionally, an esophagogastroduodenoscopy demonstrated severe esophageal candidiasis throughout the esophagus with a culture revealing Candidaglabrata resistant to fluconazole (MIC 64 mcg/ml).
The patient was enrolled into the trial and given a loading dose of oral IBX 750 mg twice a day for 2 days, followed by oral IBX 750 mg daily for a total of 54 days.
While receiving treatment, the patient gradually improved and by day 54 he was completely asymptomatic. No adverse events were reported during therapy.
One month following the discontinuation of therapy, the patient remained asymptomatic and was able to eat and drink without discomfort. A follow-up esophagogastroduodenoscopy did not detect any esophageal candidiasis and 2 months later the feeding tube was removed.
The patient was observed again at a 9 month follow-up and remained asymptomatic and was gaining weight.
“This report demonstrates the efficacy of IBX in a patient with severe recalcitrant and refractory [esophageal candidiasis], and highlights the potential for using IBX to manage difficult to treat azole resistant and refractory candidiasis,” the investigators concluded.
Is there a cure? How long until we find it? And will it work for the majority of people living with HIV?
Contagion® is a fully integrated news resource covering all areas of infectious disease. Through our website, quarterly journal, email newsletters, social media outlets, and Outbreak Monitor we provide practitioners and specialists with disease-specific information designed to improve patient outcomes and assist with the identification, diagnosis, treatment, and prevention of infectious diseases. Our mission is to assure that the healthcare community and public have the knowledge to make more informed choices and have a positive impact on patient outcomes.
2 Clarke Drive
Cranbury, NJ 08512