FDA Approves Ibrexafungerp (Brexafemme) for the Treatment of Vulvovaginal Candidiasis

Antifungals with novel mechanisms of action have not emerged in the two decades since the echinocandins were developed in 2001. Therefore, the recent U.S. FDA approval of ibrexafungerp (Brexafemme), a first-in-class triterpenoid antifungal for the treatment of vulvovaginal candidiasis, represents a landmark. Ibrexafungerp's mechanism of action resembles that of the echinocandins in that it inhibits the biosynthesis of β-(1,3)-D-glucan, a key constituent of the fungal cell wall. Its activity is similar to the echinocandins in covering Candida spp. (while also including multidrug-resistant C. auris as well as other azole- and echinocandin-resistant species) and Aspergillus spp. Like the echinocandins, ibrexafungerp has a favorable safety and …