azole + anidulafungin

azole + anidulafungin is a combination antifungal regimen being investigated by Erasmus Medical Center for the treatment of invasive aspergillosis (IA). This combination therapy pairs a triazole antifungal—typically voriconazole, isavuconazole, or posaconazole—with anidulafungin, an echinocandin. The mechanism of action involves a dual-target approach to fungal cell integrity: the azole component inhibits the enzyme lanosterol 14-alpha-demethylase (CYP51), which is essential for the synthesis of ergosterol in the fungal cell membrane, while anidulafungin inhibits 1,3-beta-D-glucan synthase, preventing the synthesis of 1,3-beta-D-glucan, a critical structural component of the fungal cell wall. This combination is being evaluated in a Phase 3 pragmatic superiority trial to determine if initial combination therapy can decrease overall mortality compared to triazole monotherapy in immunocompromised and ICU patients with invasive aspergillosis.

Other names

Azole-echinocandin combination therapyAzole-anidulafungin combination