Invasive
aspergillosis remains a major cause of death among the immunocompromised population and those receiving long-term immunosuppressive therapy. In light of increased
azole resistance, variable outcomes with existing
echinocandin monotherapy and combination
therapy, and persistent high mortality rates, new
antifungal agents for the treatment of invasive
aspergillosis are clearly needed.
SCY-078 is the first-in-class
triterpenoid antifungal, a novel class of
glucan synthase inhibitors with broad in vitro and in vivo activity against a broad spectrum of Candida and Aspergillus species. In vitro testing of clinical strains of Aspergillus fumigatus and non-fumigatus Aspergillus strains showed that
SCY-078 had potent fungistatic activity (minimum effective concentration for 90% of strains tested = 0.125 μg/ml) compared with the activities of
amphotericin B (MIC90 = 8 μg/ml) and
voriconazole (MIC90 = 2 μg/ml). Testing of
SCY-078 in combination with
isavuconazole or
voriconazole demonstrated synergistic activity against the majority of the
azole-susceptible strains tested, and
SCY-078 in combination with
amphotericin B was synergistic against the
azole-susceptible strains, as well as one known resistant cyp51A mutant.
SCY-078 may be an important additional antifungal for first-line or salvage monotherapy or combination treatment of invasive
aspergillosis.