Extrapolating Antifungal Animal Data to Humans - Is it reliable?

Abstract

Purpose of review: This article aimed to review animal models of antifungals and identifies human literature to assess if the extrapolation of results is reliable.

Recent findings: Animal studies have helped identify AUC/MIC targets for new drugs and formulations such as isavuconazole and delayed release posaconazole that have translated to successful outcomes in humans. Models have also been influential in the identification of possible combination therapies for the treatment of aspergillosis, such as voriconazole and echinocandins. However, challenges are endured with animal models when it comes to replicating the pharmacokinetics of humans which has been exemplified with the newest itraconazole formulation. Additionally, animal models have displayed a survival benefit with the use of iron chelators and amphotericin for mucormycosis which was not demonstrated in humans.

Summary: Animal models have been a staple in the development and optimization of antifungal agents. They afford the ability to investigate uncommon diseases, such as invasive fungal infections, that would otherwise take years and many resources to complete. Although there are many benefits of animal models there are also shortcomings. This is why the reliability of extrapolating data from animal models to humans is often scrutinized.

Keywords: Amphotericin B; Anidulafungin; Animal Model; Caspofungin; Echinocandin; Fluconazole; Invasive Fungal Infection; Isavuconazole; Itraconazole; Micafungin; Murine; Pharmacodynamics; Posaconazole; Rabbit; Rezafungin; Triazole; Voriconazole.