Ibrexafungerp (formerly SCY-078 or MK-3118) is a first-in-class
triterpenoid antifungal or "fungerp" that inhibits biosynthesis of β-(1,3)-D-glucan in the fungal cell wall, a mechanism of action similar to that of
echinocandins. Distinguishing characteristics of
ibrexafungerp include oral bioavailability, a favourable safety profile, few
drug-drug interactions, good tissue penetration, increased activity at low pH and activity against multi-
drug resistant isolates including C. auris and C. glabrata. In vitro data has demonstrated broad and potent activity against Candida and Aspergillus species. Importantly,
ibrexafungerp also has potent activity against
azole-resistant isolates, including biofilm-forming Candida spp., and
echinocandin-resistant isolates. It also has activity against the asci form of Pneumocystis spp., and other pathogenic fungi including some non-Candida yeasts and non-Aspergillus moulds. In vivo data have shown IBX to be effective for treatment of
candidiasis and
aspergillosis.
Ibrexafungerp is effective for the treatment of acute
vulvovaginal candidiasis in completed phase 3 clinical trials.