Ibrexafungerp: A First-in-Class Oral Triterpenoid Glucan Synthase Inhibitor.

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 and In vitro data has demonstrated broad and potent activity against and species. Importantly, ibrexafungerp also has potent activity against azole-resistant isolates, including biofilm-forming spp., and echinocandin-resistant isolates. It also has activity against the asci form of spp., and other pathogenic fungi including some non- yeasts and non- 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.