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Liposomal amphotericin B + isavuconazole is a combination antifungal regimen currently being evaluated in a Phase 4 clinical trial for the treatment of pulmonary mucormycosis. The regimen combines two potent antifungal agents with distinct mechanisms of action: liposomal amphotericin B (AmBisome), a polyene that binds to ergosterol in the fungal cell membrane to create lethal pores, and isavuconazole (Cresemba), a triazole that inhibits the enzyme lanosterol 14-alpha-demethylase (CYP51), thereby blocking the synthesis of ergosterol. This combination is hypothesized to provide synergistic or additive effects against Mucorales species, which are the causative agents of mucormycosis and are associated with high mortality rates in immunocompromised individuals. The trial, led by investigator Bin Cao, aims to establish whether this combination therapy offers improved efficacy and safety compared to liposomal amphotericin B monotherapy.
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