by Chu WY, Fahal AH, Ahmed ES, Bakhiet SM, Bakhiet OE, Fahal LA, Mohamed AA, Wadaa ES, Mohamedelamin MEN, Bahar HYA, Attalla EES, Mhmoud NA, Musa AM, Oyieko P, Egondi T, Brüggemann RJ, Hata K, Strub-Wourgaft N, Alves F, Nyaoke BA, Zijlstra EE, Dorlo TPC. The Journal of Infectious Diseases 2025, jiaf279. doi: 10.1093/infdis/jiaf279/8151980
Summary: The authors of this study aimed to characterize the pharmacokinetics-pharmacodynamics (PK-PD) of fosravuconazole, itraconazole, and hydroxyitraconazole within the first clinical trial on eumycetoma. Nonlinear mixed-effects modeling was used to develop population PK models in 52 patients receiving three daily loading doses followed by weekly fosravuconazole (200 mg or 300 mg) or twice daily itraconazole (total 400 mg), both over 12 months. Despite a large range in antifungal exposure, no significant relationships were found between drug exposure and lesion size reduction or complete cure, indicating no additional benefit of 300 mg over 200 mg fosravuconazole. The 200 mg fosravuconazole dose is preferred for future use over 300 mg, as it lowers pill burden and enhances cost-effectiveness.
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