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Erschienen in: Drugs 7/2015

01.05.2015 | R&D Insight Report

Isavuconazonium: First Global Approval

verfasst von: Paul L. McCormack

Erschienen in: Drugs | Ausgabe 7/2015

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Abstract

Isavuconazonium (Cresemba®) is a water-soluble prodrug of the triazole antifungal isavuconazole (BAL 4815), a 14-α-demethylase inhibitor, under development by Basilea Pharmaceutica International Ltd and Astellas Pharma Inc. Isavuconazonium, in both its intravenous and oral formulations, was approved for the treatment of invasive aspergillosis and invasive mucormycosis (formerly termed zygomycosis) in the US in March 2015. Isavuconazonium is under regulatory review in the EU for invasive aspergillosis and mucormycosis. It is also under phase III development worldwide for the treatment of invasive candidiasis and candidaemia. This article summarizes the milestones in the development of isavuconazonium leading to the first approval for invasive aspergillosis and mucormycosis.
Literatur
1.
Zurück zum Zitat Falci DR, Pasqualotto AC. Profile of isavuconazole and its potential in the treatment of severe invasive fungal infections. Infect Drug Resist. 2013;6:163–74.PubMedCentralPubMed Falci DR, Pasqualotto AC. Profile of isavuconazole and its potential in the treatment of severe invasive fungal infections. Infect Drug Resist. 2013;6:163–74.PubMedCentralPubMed
9.
Zurück zum Zitat Thompson GR 3rd, Wiederhold NP. Isavuconazole: a comprehensive review of spectrum of activity of a new triazole. Mycopathologia. 2010;170(5):291–313.CrossRefPubMed Thompson GR 3rd, Wiederhold NP. Isavuconazole: a comprehensive review of spectrum of activity of a new triazole. Mycopathologia. 2010;170(5):291–313.CrossRefPubMed
10.
Zurück zum Zitat Lepak AJ, Marchillo K, Vanhecker J, et al. Isavuconazole (BAL4815) pharmacodynamic target determination in an in vivo murine model of invasive pulmonary aspergillosis against wild-type and CYP51 mutant isolates of Aspergillus fumigatus. Antimicrob Agents Chemother. 2013;57(12):6284–9.CrossRefPubMedCentralPubMed Lepak AJ, Marchillo K, Vanhecker J, et al. Isavuconazole (BAL4815) pharmacodynamic target determination in an in vivo murine model of invasive pulmonary aspergillosis against wild-type and CYP51 mutant isolates of Aspergillus fumigatus. Antimicrob Agents Chemother. 2013;57(12):6284–9.CrossRefPubMedCentralPubMed
11.
Zurück zum Zitat Lepak AJ, Marchillo K, VanHecker J, et al. Isavuconazole pharmacodynamic target determination for Candida species in an in vivo murine disseminated candidiasis model. Antimicrob Agents Chemother. 2013;57(11):5642–8.CrossRefPubMedCentralPubMed Lepak AJ, Marchillo K, VanHecker J, et al. Isavuconazole pharmacodynamic target determination for Candida species in an in vivo murine disseminated candidiasis model. Antimicrob Agents Chemother. 2013;57(11):5642–8.CrossRefPubMedCentralPubMed
12.
Zurück zum Zitat Majithiya J, Sharp A, Parmar A, et al. Efficacy of isavuconazole, voriconazole and fluconazole in temporarily neutropenic murine models of disseminated Candida tropicalis and Candida krusei. J Antimicrob Chemother. 2009;63(1):161–6.CrossRefPubMedCentralPubMed Majithiya J, Sharp A, Parmar A, et al. Efficacy of isavuconazole, voriconazole and fluconazole in temporarily neutropenic murine models of disseminated Candida tropicalis and Candida krusei. J Antimicrob Chemother. 2009;63(1):161–6.CrossRefPubMedCentralPubMed
13.
Zurück zum Zitat Warn PA, Sharp A, Parmar A, et al. Pharmacokinetics and pharmacodynamics of a novel triazole, isavuconazole: mathematical modeling, importance of tissue concentrations, and impact of immune status on antifungal effect. Antimicrob Agents Chemother. 2009;53(8):3453–61.CrossRefPubMedCentralPubMed Warn PA, Sharp A, Parmar A, et al. Pharmacokinetics and pharmacodynamics of a novel triazole, isavuconazole: mathematical modeling, importance of tissue concentrations, and impact of immune status on antifungal effect. Antimicrob Agents Chemother. 2009;53(8):3453–61.CrossRefPubMedCentralPubMed
14.
Zurück zum Zitat Luo G, Gebremariam T, Lee H, et al. Isavuconazole therapy protects immunosuppressed mice from mucormycosis. Antimicrob Agents Chemother. 2014;58(4):2450–3.CrossRefPubMedCentralPubMed Luo G, Gebremariam T, Lee H, et al. Isavuconazole therapy protects immunosuppressed mice from mucormycosis. Antimicrob Agents Chemother. 2014;58(4):2450–3.CrossRefPubMedCentralPubMed
15.
Zurück zum Zitat Schmitt-Hoffmann A, Roos B, Maares J, et al. Mulitple-dose pharmacokinetics and safety of the new antifungal triazole BAL4815 after intravenous infusion and oral administration of its prodrug, BAL8557, in healthy volunteers. Antimicrob Agents Chemother. 2006;50(1):286–93.CrossRefPubMedCentralPubMed Schmitt-Hoffmann A, Roos B, Maares J, et al. Mulitple-dose pharmacokinetics and safety of the new antifungal triazole BAL4815 after intravenous infusion and oral administration of its prodrug, BAL8557, in healthy volunteers. Antimicrob Agents Chemother. 2006;50(1):286–93.CrossRefPubMedCentralPubMed
16.
Zurück zum Zitat Schmitt-Hoffmann A, Roos B, Spickermann J, et al. No relevant food effects in man on isavuconazole oral pharmacokinetics preliminary data (abstract no. A-008). In: 48th interscience conference on antimicrobial agents and chemotherapy/Infectious Diseases Society of America 46th annual meeting. 2008. Schmitt-Hoffmann A, Roos B, Spickermann J, et al. No relevant food effects in man on isavuconazole oral pharmacokinetics preliminary data (abstract no. A-008). In: 48th interscience conference on antimicrobial agents and chemotherapy/Infectious Diseases Society of America 46th annual meeting. 2008.
17.
Zurück zum Zitat Schmitt-Hoffmann A, Roos B, Heep M, et al. Single-ascending-dose pharmacokinetics and safety of the novel broad-spectrum antifungal triazole BAL4815 after intravenous infusions (50, 100. and 200 milligrams) and oral administrations (100, 200, and 400 milligrams) of its prodrug, BAL8557, in healthy volunteers. Antimicrob Agents Chemother. 2006;50(1):279–85.CrossRefPubMedCentralPubMed Schmitt-Hoffmann A, Roos B, Heep M, et al. Single-ascending-dose pharmacokinetics and safety of the novel broad-spectrum antifungal triazole BAL4815 after intravenous infusions (50, 100. and 200 milligrams) and oral administrations (100, 200, and 400 milligrams) of its prodrug, BAL8557, in healthy volunteers. Antimicrob Agents Chemother. 2006;50(1):279–85.CrossRefPubMedCentralPubMed
18.
Zurück zum Zitat Schmitt-Hoffmann A, Roos B, Spickermann J, et al. Effect of mild and moderate liver disease on the pharmacokinetics of isavuconazole after intravenous and oral administration of a single dose of the prodrug BAL8557. Antimicrob Agents Chemother. 2009;53(11):4885–90.CrossRefPubMedCentralPubMed Schmitt-Hoffmann A, Roos B, Spickermann J, et al. Effect of mild and moderate liver disease on the pharmacokinetics of isavuconazole after intravenous and oral administration of a single dose of the prodrug BAL8557. Antimicrob Agents Chemother. 2009;53(11):4885–90.CrossRefPubMedCentralPubMed
19.
Zurück zum Zitat Yamazaki T, Pearlman H, Kowalski DL, et al. Effect of multiple doses of ketoconazole on the pharmacokinetics of isavuconazole in healthy subjects (abstract no. A-695). In: 54th interscience conference on antimicrobial agents and chemotherapy. 2014. Yamazaki T, Pearlman H, Kowalski DL, et al. Effect of multiple doses of ketoconazole on the pharmacokinetics of isavuconazole in healthy subjects (abstract no. A-695). In: 54th interscience conference on antimicrobial agents and chemotherapy. 2014.
20.
Zurück zum Zitat Yamazaki T, Desai A, Kowalski D. Pharmacokinetic (PK) interaction between isavuconazole (ISA) and a fixed-dose combination of lopinavir [LPV] 400 mg/ritonavir [RTV] 100 mg in healthy subjects (abstract no. 722). In: IDWeek. 2013. Yamazaki T, Desai A, Kowalski D. Pharmacokinetic (PK) interaction between isavuconazole (ISA) and a fixed-dose combination of lopinavir [LPV] 400 mg/ritonavir [RTV] 100 mg in healthy subjects (abstract no. 722). In: IDWeek. 2013.
21.
Zurück zum Zitat Townsend R, Yamazaki T, Kowalski D, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of oral contraceptive with ethinyl estradiol and norethindrone in healthy subjects [abstract no. PII-088]. Clin Pharmacol Ther. 2014;95(Suppl 1):S90–1. Townsend R, Yamazaki T, Kowalski D, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of oral contraceptive with ethinyl estradiol and norethindrone in healthy subjects [abstract no. PII-088]. Clin Pharmacol Ther. 2014;95(Suppl 1):S90–1.
22.
Zurück zum Zitat Desai A, Zadeikis N, Howieson C, et al. Isavuconazole does not affect prednisolone pharmacokinetics in healthy subjects following coadministration of multiple dose isavuconazole. Clin Pharmacol Ther. 2013;93:S39. Desai A, Zadeikis N, Howieson C, et al. Isavuconazole does not affect prednisolone pharmacokinetics in healthy subjects following coadministration of multiple dose isavuconazole. Clin Pharmacol Ther. 2013;93:S39.
23.
Zurück zum Zitat Desai A, Pearlman H, Yamazaki T, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP1A2 substrate caffeine and CYP2C8 substrate repaglinide in healthy subjects (abstract no. A-696). In: 54th interscience conference on antimicrobial agents and chemotherapy. 2014. Desai A, Pearlman H, Yamazaki T, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP1A2 substrate caffeine and CYP2C8 substrate repaglinide in healthy subjects (abstract no. A-696). In: 54th interscience conference on antimicrobial agents and chemotherapy. 2014.
24.
Zurück zum Zitat Desai A, Yamazaki T, Lademacher C, et al. Effect of multiple doses of isavuconzole on the pharmacokinetics of methadone in healthy subjects (abstract no. R6335). In: American Association of Pharmaceutical Scientists annual meeting. 2013. Desai A, Yamazaki T, Lademacher C, et al. Effect of multiple doses of isavuconzole on the pharmacokinetics of methadone in healthy subjects (abstract no. R6335). In: American Association of Pharmaceutical Scientists annual meeting. 2013.
25.
Zurück zum Zitat Yamazaki T, Pearlman H, Kowalski D, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP3A4 substrate atorvastatin in healthy subjects (abstract no. A-449). In: 52nd interscience conference on antimicrobial agents and chemotherapy. 2012. Yamazaki T, Pearlman H, Kowalski D, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP3A4 substrate atorvastatin in healthy subjects (abstract no. A-449). In: 52nd interscience conference on antimicrobial agents and chemotherapy. 2012.
26.
Zurück zum Zitat Desai A, Yamazaki T, Lademacher C, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP2D6 substrate dextromethorphan in healthy subjects (abstract no. R6334). In: American Association of Pharmaceutical Scientists annual meeting. 2013. Desai A, Yamazaki T, Lademacher C, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP2D6 substrate dextromethorphan in healthy subjects (abstract no. R6334). In: American Association of Pharmaceutical Scientists annual meeting. 2013.
27.
Zurück zum Zitat Desai A, Zadeikis N, Pearlman H. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP3A4 substrate midazolam in healthy volunteers (abstract no. A-1936). In: 52nd interscience conference on antimicrobial agents and chemotherapy. 2012. Desai A, Zadeikis N, Pearlman H. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP3A4 substrate midazolam in healthy volunteers (abstract no. A-1936). In: 52nd interscience conference on antimicrobial agents and chemotherapy. 2012.
28.
Zurück zum Zitat Yamazaki T, Zadeikis N, Pearlman H, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of sirolimus in healthy subjects. Clin Pharmacol Ther. 2013;93:S114. Yamazaki T, Zadeikis N, Pearlman H, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of sirolimus in healthy subjects. Clin Pharmacol Ther. 2013;93:S114.
29.
Zurück zum Zitat Desai A, Zadeikis N, Pearlman H, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP3A4 substrate tacrolimus in healthy subjects. Clin Pharmacol Ther. 2013;93:S39–40. Desai A, Zadeikis N, Pearlman H, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP3A4 substrate tacrolimus in healthy subjects. Clin Pharmacol Ther. 2013;93:S39–40.
30.
Zurück zum Zitat Desai A, Pearlman H, Yamazaki T, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP2B6 substrate bupropion in healthy subjects (abstract no. A-450). In: 53rd interscience conference on antimicrobial agents and chemotherapy. 2013. Desai A, Pearlman H, Yamazaki T, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of CYP2B6 substrate bupropion in healthy subjects (abstract no. A-450). In: 53rd interscience conference on antimicrobial agents and chemotherapy. 2013.
31.
Zurück zum Zitat Townsend R, Desai A, Howieson C, et al. Clinical considerations for coadministration of the novel antifungal isavuconazole with immunosuppressive agents (abstract no. P199). Transplant Int. 2013;26(Suppl 2):227. Townsend R, Desai A, Howieson C, et al. Clinical considerations for coadministration of the novel antifungal isavuconazole with immunosuppressive agents (abstract no. P199). Transplant Int. 2013;26(Suppl 2):227.
32.
Zurück zum Zitat Desai A, Zadeikis N, Breese N, et al. Isavuconazole does not significantly affect the pharmacokinetics of p-glycoprotein substrate digoxin in healthy subjects. Clin Pharmacol Ther. 2013;93:S40. Desai A, Zadeikis N, Breese N, et al. Isavuconazole does not significantly affect the pharmacokinetics of p-glycoprotein substrate digoxin in healthy subjects. Clin Pharmacol Ther. 2013;93:S40.
33.
Zurück zum Zitat Desai A, Yamazaki T, Kowalski D, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of metformin in healthy subjects (abstract no. PI-072). Clin Pharmacol Ther. 2014;95(Suupl 1):S41. Desai A, Yamazaki T, Kowalski D, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of metformin in healthy subjects (abstract no. PI-072). Clin Pharmacol Ther. 2014;95(Suupl 1):S41.
34.
Zurück zum Zitat Yamazaki T, Desai A, Kowalski D, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of methotrexate in healthy subjects (abstract no. PII-095). Clin Pharmacol Ther. 2014;95(Suppl 1):S93. Yamazaki T, Desai A, Kowalski D, et al. Effect of multiple doses of isavuconazole on the pharmacokinetics of methotrexate in healthy subjects (abstract no. PII-095). Clin Pharmacol Ther. 2014;95(Suppl 1):S93.
35.
Zurück zum Zitat Maertens J, Patterson T, Rahav G, et al. A phase 3 randomised, double-blind trial evaluating isavuconazole vs. voriconazole for the primary treatment of invasive fungal disease caused by Aspergillus spp. or other filamentous fungi (SECURE) (abstract no. O230a). In: 24th European Congress of Clinical Microbiology and Infectious Diseases. 2014. Maertens J, Patterson T, Rahav G, et al. A phase 3 randomised, double-blind trial evaluating isavuconazole vs. voriconazole for the primary treatment of invasive fungal disease caused by Aspergillus spp. or other filamentous fungi (SECURE) (abstract no. O230a). In: 24th European Congress of Clinical Microbiology and Infectious Diseases. 2014.
36.
Zurück zum Zitat Thompson GR, Rendon A, Santos R, et al. Outcomes in patients with invasive fungal disease caused by dimorphic fungi treated with isavuconazole: experience from the VITAL trial (abstract no. M-1775). In: 54th Interscience Conference On Antimicrobial Agents And Chemotherapy. 2014. Thompson GR, Rendon A, Santos R, et al. Outcomes in patients with invasive fungal disease caused by dimorphic fungi treated with isavuconazole: experience from the VITAL trial (abstract no. M-1775). In: 54th Interscience Conference On Antimicrobial Agents And Chemotherapy. 2014.
37.
Zurück zum Zitat Queiroz-Telles F, Cornely OA, Perfect J, et al. Successful outcomes in patients with invasive fungal disease due to C. gattii and C. neoformans treated with isavuconazole: experience from the VITAL trial (abstract no. M-1773). In: 54th interscience conference on antimicrobial agents and chemotherapy. 2014. Queiroz-Telles F, Cornely OA, Perfect J, et al. Successful outcomes in patients with invasive fungal disease due to C. gattii and C. neoformans treated with isavuconazole: experience from the VITAL trial (abstract no. M-1773). In: 54th interscience conference on antimicrobial agents and chemotherapy. 2014.
38.
Zurück zum Zitat Viljoen J, Azie N, Schmitt-Hoffmann AH, et al. A phase 2, randomized, double-blind, multicenter trial to evaluate the safety and efficacy of three dosing regimens of isavuconazole compared with fluconazole in patients with uncomplicated esophageal candidiasis. Antimicrob Agents Chemother. 2015;59(3):1671–9.CrossRefPubMedCentralPubMed Viljoen J, Azie N, Schmitt-Hoffmann AH, et al. A phase 2, randomized, double-blind, multicenter trial to evaluate the safety and efficacy of three dosing regimens of isavuconazole compared with fluconazole in patients with uncomplicated esophageal candidiasis. Antimicrob Agents Chemother. 2015;59(3):1671–9.CrossRefPubMedCentralPubMed
39.
Zurück zum Zitat Cornely OA, Bohme A, Schmitt-Hoffmann A, et al. Safety and pharmacokinetics of isavuconazole as antifungal prophylaxis in acute myeloid leukemia patients with neutropenia: results of a phase 2, dose escalation study. Antimicrob Agents Chemother. 2015;59(4):2078–85.CrossRefPubMedCentralPubMed Cornely OA, Bohme A, Schmitt-Hoffmann A, et al. Safety and pharmacokinetics of isavuconazole as antifungal prophylaxis in acute myeloid leukemia patients with neutropenia: results of a phase 2, dose escalation study. Antimicrob Agents Chemother. 2015;59(4):2078–85.CrossRefPubMedCentralPubMed
40.
Zurück zum Zitat Basilea Pharmaceutica. Basilea reports protocol amendment resulting in earlier completion of isavuconazole phase 3 invasive candidiasis study (media release). 2014. http://www.basilea.com. Basilea Pharmaceutica. Basilea reports protocol amendment resulting in earlier completion of isavuconazole phase 3 invasive candidiasis study (media release). 2014. http://​www.​basilea.​com.
Metadaten
Titel
Isavuconazonium: First Global Approval
verfasst von
Paul L. McCormack
Publikationsdatum
01.05.2015
Verlag
Springer International Publishing
Erschienen in
Drugs / Ausgabe 7/2015
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI
https://doi.org/10.1007/s40265-015-0398-6

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