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SHR Neuro Cancer Cardio Lipid Metab Microb

Boyer, J; Feys, S; Zsifkovits, I; Hoenigl, M; Egger, M.
Treatment of Invasive Aspergillosis: How It's Going, Where It's Heading.
Mycopathologia. 2023; 188(5):667-681 Doi: 10.1007/s11046-023-00727-z [OPEN ACCESS]
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Leading authors Med Uni Graz

Boyer Johannes

Egger Matthias Florian

Co-authors Med Uni Graz

Hönigl Martin

Zsifkovits Isabella

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Abstract:

Despite improvements in treatment and diagnostics over the last two decades, invasive aspergillosis (IA) remains a devastating fungal disease. The number of immunocompromised patients and hence vulnerable hosts increases, which is paralleled by the emergence of a rise in IA cases. Increased frequencies of azole-resistant strains are reported from six continents, presenting a new challenge for the therapeutic management. Treatment options for IA currently consist of three classes of antifungals (azoles, polyenes, echinocandins) with distinctive advantages and shortcomings. Especially in settings of difficult to treat IA, comprising drug tolerance/resistance, limiting drug-drug interactions, and/or severe underlying organ dysfunction, novel approaches are urgently needed. Promising new drugs for the treatment of IA are in late-stage clinical development, including olorofim (a dihydroorotate dehydrogenase inhibitor), fosmanogepix (a Gwt1 enzyme inhibitor), ibrexafungerp (a triterpenoid), opelconazole (an azole optimized for inhalation) and rezafungin (an echinocandin with long half-life time). Further, new insights in the pathophysiology of IA yielding immunotherapy as a potential add-on therapy. Current investigations show encouraging results, so far mostly in preclinical settings. In this review we discuss current treatment strategies, give an outlook on possible new pharmaceutical therapeutic options, and, lastly, provide an overview of the ongoing research in immunotherapy for IA.

Find related publications in this database (using NLM MeSH Indexing)

Humans - administration & dosage

Aspergillosis - diagnosis, drug therapy, microbiology

Antifungal Agents - therapeutic use, pharmacology

Mycoses - drug therapy

Invasive Fungal Infections - diagnosis, drug therapy

Azoles - therapeutic use, pharmacology

Drug Resistance, Fungal - administration & dosage

Find related publications in this database (Keywords)

Invasive aspergillosis

Therapy

Immunotherapy

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