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Olorofim is a first-in-class antifungal agent belonging to the orotomide class, developed for the treatment of difficult-to-treat invasive and rare fungal mold infections. It acts as a reversible inhibitor of the enzyme dihydroorotate dehydrogenase (DHODH), which is essential in the de novo pyrimidine biosynthesis pathway in fungi. By inhibiting DHODH, olorofim disrupts pyrimidine synthesis, leading to impaired DNA synthesis and ultimately fungal cell death. Olorofim demonstrates potent activity against a range of molds including azole-resistant Aspergillus species, Lomentospora prolificans, Scedosporium species, Scopulariopsis species, and dimorphic fungi such as Coccidioides spp. It is administered orally and has been granted orphan drug status and Breakthrough Therapy designation for several invasive fungal indications due to its novel mechanism and efficacy in cases refractory or intolerant to standard therapies[1][3][4][5].
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