ECCMID 2023 highlights in fungal infections – Diagnostics, antifungal resistance and emerging antifungal treatments: David Denning

Fungal infections pose a high risk in patients with a weakened immune system, despite the development of new antifungal therapeutics, antifungal resistance is an increasing concern when trying to treat patients. We were delighted to catch up with Prof. David Denning (The University of Manchester, Manchester, United Kingdom) around his highlights from ECCMID, including new diagnostics and the use of diagnostics in fungal infections, challenges in antifungal resistance, and the development of new antifungal treatments.

‘What’s new in diagnosis and treatment of chronic pulmonary aspergillosis’ (Meet the expert session: ME025) was presented at ECCMID 2023, 15-18 April, 2023, Copenhagen, Denmark.

Questions

1. What are the hot topics and clinical trial highlights from ECCMID 2023? (0:26)

Disclosures: David Denning and family hold Founder shares in F2G Ltd, a University of Manchester spin-out antifungal discovery company, and share options in TFF Pharma. He acts or has recently acted as a consultant to Pulmatrix, Pulmocide, Biosergen, TFF Pharmaceuticals, Pfizer, Omega, Novacyt, Rostra Therapeutics, MucPharm and Cipla. He sat on the DSMB for a SARS CoV2 vaccine trial, chairs a Data Review Committee for Pulmocide and as Phase 1 Medical Monitor for Biosergen. In the last 3 years, he has been paid for talks on behalf of Hikma, Gilead, BioRad, Basilea and Pfizer. He is a longstanding member of the Infectious Disease Society of America Aspergillosis Guidelines group, the European Society for Clinical Microbiology and Infectious Diseases Aspergillosis Guidelines group and recently joined the One World Guideline for Aspergillosis.

Support: Interview and filming supported by Touch Medical Media Ltd. Interview conducted by Katey Gabrysch and Victoria Jones.

Filmed in coverage of the 33rd European Congress of Clinical Microbiology & Infectious Diseases.

Click here for more content on fungal infections. For further ECCMID 2023 highlights visit here.

Transcript

What are the hot topics and clinical trial highlights from ECCMID 2023? (0:26)

So ECCMID’s a big meeting with a lot of new data presented. Most of the improvements and changes and increased understanding that we have seen is incremental changes from things that we’ve sort of known before. What are the big highlights for me? I think the tremendous interest in new diagnostics and the use of those diagnostics in existing or new settings is really important. Examples of that might be cell free DNA, PCR, multiplex PCR systems or detection systems. The increased use of maldi-tof identifying rare fungi but also looking at resistance or examples of that. Another area that’s a really hot topic here is antifungal resistance, and there’s a lot of work on antifungal resistance being presented of all sorts. Perhaps the things that are most concerning to me are the very substantial increase in resistance to terbinafine and sometimes itraconazole into dermatophyte infections or skin infections, typically tinea corporis which have emanated from India, but they’re now being seen across the world. And there was a poster from San Antonio, which runs a reference laboratory in the US and they’ve seen a great increase in the number of resistant dermatophytes. And it’s, it’s good to see that the EUCAST AFST group are working on better methods to, to diagnose and detect resistance in that group. We’re also seeing an increase in resistance in Aspergillus. This has been talked about and discussed many times before. And it’s sort of been started to be documented in the mid-nineties, but it’s growing and growing and growing and now again there’s a big change in the US, there’s more resistance in Spain and other countries being described. We’ve also seen some really nice piece of work with new, new antifungals coming through. Olorofim appears to be doing quite well. I know a little bit about this because it was a company I founded many, many years ago in Manchester. I don’t actually get involved in any of the clinical studies any more, but it’s really nice to see their data maturing. The patients who were untreatable, patients recovering there from these difficult fungal infections and tolerating drugs for a very long time. Ibrexafungerp has recently been approved by the US FDA for vaginal candidiasis. They are exploring multiple other indications of this. We saw an interesting poster presented on its use for urine infections with multidrug resistant Candida infections, which is also really encouraging. Rezafungin, which is being marketed in Europe by Mundipharma is out the door and we’re starting to see the results of those big candidaemia studies being presented and they too are starting to explore other indications such as prophylaxis and they’re interested in aspergillosis as well. Also once a week IVs as opposed to daily IVS, really could transform hospital, at home care for many, many patients. There are many other antifungals sort of earlier in the pipeline or phase two – we will see, in future years increasing incidence of that. But overall, the number of people, and the engagement in multiple countries, multiple companies is really very good because we really do need better diagnostics, access to diagnostics and access to treatments across the world.

Subtitles and transcript are autogenerated.