Anidulafungin

Drugs. 2004;64(19):2249-58; discussion 2259-60. doi: 10.2165/00003495-200464190-00011.

Abstract

Anidulafungin is a novel antifungal agent which, like other echinocandins, inhibits beta-(1,3)-D-glucan synthase and disrupts fungal cell-wall synthesis. It has marked antifungal activity against a broad spectrum of Candida spp. and Aspergillus spp., including amphotericin B- and triazole-resistant strains. In clinical trials, anidulafungin has primarily been evaluated in patients with oesophageal and invasive candidiasis. Preliminary data are emerging for other indications such as invasive aspergillosis. In a large, multicentre, double-blind, double-dummy, randomised trial in patients with oesophageal candidiasis, intravenous anidulafungin 50 mg/day was as effective as oral fluconazole 100 mg/day regarding end-of-treatment rates of endoscopic cure and clinical and microbiological success. Duration of treatment was approximately 2-3 weeks, and patients in both groups received a loading dose of study drug (twice the daily maintenance dose) on day 1. Anidulafungin is generally well tolerated. Across the dosage range 50-100 mg/day, adverse events appear not to be dose- or infusion-related. In the largest clinical trial to date, the most common treatment-related adverse events were phlebitis/thrombophlebitis, headache, nausea, vomiting and pyrexia.

Publication types

  • Comparative Study

MeSH terms

  • Anidulafungin
  • Animals
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use*
  • Aspergillosis / diagnosis
  • Aspergillosis / drug therapy
  • Aspergillus / classification
  • Aspergillus / drug effects
  • Candida / classification
  • Candida / drug effects
  • Candidiasis / complications
  • Candidiasis / diagnosis
  • Candidiasis / drug therapy
  • Cell Wall / drug effects
  • Cell Wall / metabolism
  • Clinical Trials as Topic
  • Drug Administration Schedule
  • Drug Evaluation, Preclinical / methods
  • Echinocandins
  • Esophageal Diseases / complications
  • Esophageal Diseases / diagnosis
  • Esophageal Diseases / drug therapy
  • Glucosyltransferases / antagonists & inhibitors
  • Glucosyltransferases / pharmacology
  • Glucosyltransferases / therapeutic use
  • Humans
  • Infusions, Intravenous
  • Injections, Intravenous
  • Molecular Structure
  • New Zealand
  • Peptides, Cyclic / adverse effects
  • Peptides, Cyclic / pharmacokinetics*
  • Peptides, Cyclic / therapeutic use*
  • Time Factors
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Echinocandins
  • Peptides, Cyclic
  • Anidulafungin
  • Glucosyltransferases
  • 1,3-beta-glucan synthase