Considering Rezafungin For Candidemia and Invasive Candidiasis

The antifungal market is limited in terms of development, and when rezafungin (Rezzayo) was FDA approved back in 2023, it became the first new therapy approved to treat candidemia and invasive candidiasis in more than 10 years.

Since its approval, additional studies have been done, and in one pooled analysis study, rezafungin was shown to be noninferior to caspofungin for candidemia and invasive candidiasis for 30 day mortality.

George Thompson, MD, professor of Medicine at the University of California, Davis, School of Medicine, was an investigator during the clinical trials and describes some of the benefits in specific patients.

“I think where we've seen the most rapid adoption is people with high grade candidemia. Our ICU patients are neutropenic patients, and those are the groups that have really gotten the most advocates for this very high front-loaded exposure with rezafungin,” said Thompson. "So I think that's where we've seen most of our use thus far. It also certainly can help if someone has Candida and needs to go home, but still needs to stay on a echinocandin so that once a week infusion is certainly more convenient than a daily option.”

And in terms of safety, rezafungin is in a class of therapies that has shown to be have a favorable profile.

“That class as a whole, the majority of the side effects we see are with too rapid of an infusion. So if it's given as a push, instead of infused over an hour, patients get a kind of a histamine-like response,” Thompson said. “We think it's very safe. we have a lot of experience with it from the phase 2 and 3 trials. And with the availability on the market now, we're not seeing toxicity with rezafungin.”