There are currently several different antifungal drugs available for treatment of aspergillosis - six approved drugs in current use: amphotericin and derivatives, itraconazole, voriconazole, posaconazole, caspofungin and flucytosine (see the Aspergillus Website Treatment section for details here).
There are currently 6 new drugs relatively close to use on aspergillosis in the clinic; isavuconazole, ravuconazole, micafungin, albaconazole, anidulafungin and SPK-843.
This sounds like a lot of choice for the clinician but unfortunately their usefullness is a little limited as most belong to only three classes of antifungal drug: the polyenes, the triazoles and the echinocandins (details here). In fact there are 6 triazoles, 2 polyenes and 3 echinocandins that are usefull to treat aspergillus infections.
This is important as all antifungals in a particular class tend to work in the same way, so the fungus can build up resistance to a whole class of antifungal drug once it has become resistant to one drug, or a particular class can be less good at treating some conditions - for example at one time there were only polyene drugs available which tended to be very toxic for some people, so when the triazoles arrived that group of people benefitted greatly as they tended to be much less toxic.
New classes of antifungal drugs are therefore much sought after. This week we saw reports in the media of news of the emergence of a new class of antifungal. f2g (a company based here in Manchester, UK) has announced that it will present research results at a forthcoming major scientific conference (ICAAC 2008). We have few details of the announcement but it looks clear that there is activity against Aspergillus in the laboratory and possibly in animal models. It is also clear that there has been no work carried out on treating patients in the clinic, so all this optimism must be tempered by the knowledge that many drugs look promising at this stage but then prove to be too problematic to use to treat humans, or have little activity against Aspergillus in patients.
If there are any more details to report when we can read the presented research we will do so in a few weeks. Until then we can only hope trials go well and this represents the beginning of the development of a new tool to use against aspergillosis.
Disclosure: f2g has as an advisor Prof David Denning who is also Senior Editor for this website, but no prior knowledge of this announcement was made available to us here at the website. We feature this announcement as an important development in antifungal research and not because any inducement was made by any member of f2g or its advisors to publish this news.