Rezzayo (rezafungin for injection) / Mundipharma, Melinta Therap, Merck (MSD) - LARVOL DELTA

A US Hospital-Perspective Decision-Analytic Model of Once-Weekly Rezafungin Versus Daily Echinocandin Therapy in Hospitalized Adults With Candidemia or Invasive Candidiasis: Potential Cost Savings From Earlier Discharge. (PubMed, Open Forum Infect Dis) - "Rezafungin was associated with higher costs when no earlier discharge occurred (+$3471) or discharge occurred only 1 day earlier (+$1475), but became cost saving with ≥2 days earlier discharge (-$556 at 2 days, -$2903 at 3 days, and -$5313 at ≥4 days). Once-weekly rezafungin reduced hospital costs versus daily echinocandins when it enabled discharge ≥2 days earlier, with greater savings when PICC placement was avoided."

Clinical • HEOR • Journal • Candidiasis

Rezafungin in ocular candidiasis: first paired plasma and aqueous-humour concentrations. (PubMed, J Infect) - No abstract available

Journal • Candidiasis

Pharmacokinetic Study of Rezafungin in Patients With Suspected Intra-Abdominal Candidiasis (clinicaltrials.gov) - P4 | N=20 | Active, not recruiting | Sponsor: Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal | Not yet recruiting ➔ Active, not recruiting | Trial completion date: Jan 2026 ➔ Feb 2027 | Trial primary completion date: Nov 2025 ➔ Dec 2026

Enrollment closed • Trial completion date • Trial primary completion date • Candidiasis

Activity of rezafungin against Aspergillus spp. that are non-wild-type to azole antifungal agents (IDWeek 2026) - No abstract available

Infectious Disease

Real-World Utilization of Rezafungin in the Treatment of Candidiasis: Analysis of a Large Healthcare National Database (IDWeek 2026) - No abstract available

Clinical • Real-world • Real-world evidence • Candidiasis • Infectious Disease

Pathogenesis and Triazole Resistance in Aspergillus fumigatus: A Narrative Review Across the Host Immune Spectrum and One Health Context. (PubMed, Infect Drug Resist) - "Novel antifungal agents, such as olorofim, fosmanogepix, rezafungin, ibrexafungerp, and T-2307, along with targeted delivery and immunomodulatory adjunct therapies for resistant aspergillosis, are also summarized. Major knowledge gaps persist regarding horizontal gene transfer of resistance mutations, cross-species transmission chains, and translational applications of environmental monitoring data. This review summarizes existing research bottlenecks and proposes integrated multi-sector prevention and control strategies from a One Health perspective to curb the growing threat of triazole-resistant aspergillosis."

Journal • Review • Gene Therapies • Pulmonary Disease • Respiratory Diseases • ARAF

Fungal Esophagitis: Molecular Insights Into Pathogenesis and Emerging Antifungal Strategies. (PubMed, Front Biosci (Landmark Ed)) - "While fluconazole remains the first-line agent for most cases, the increasing prevalence of non-albicans Candida species and drug resistance underscore the importance of alternative medications with different molecular targets. Agents such as the recently approved rezafungin as well as compounds such as ibrexafungerp and fosmanogepix, represent promising options for the treatment of refractory disease. This review synthesizes current advances in the molecular pathogenesis of fungal esophagitis, with particular emphasis on host-fungal interactions, antifungal resistance mechanisms, and novel treatment strategies. A deeper understanding of these processes is essential to improve management and to guide the development of innovative immunomodulatory and antifungal therapies."

IO biomarker • Journal • Review • Eosinophilic Esophagitis • Gastrointestinal Disorder • Human Immunodeficiency Virus • Immunology • Infectious Disease • Oncology • Solid Organ Transplantation • Transplantation • IL17A

Molecular Mechanisms, Diagnosis, and Therapeutic Strategies of Antifungal Resistance in Filamentous Fungi. (PubMed, J Fungi (Basel)) - "Precision dosing guided by therapeutic drug monitoring, combination therapy, and the introduction of novel agents (including isavuconazole, rezafungin, fosmanogepix, and olorofim) are progressively improving clinical outcomes. Looking ahead, global surveillance and multisectoral collaboration are essential to deepen our understanding of resistance evolution, accelerate the clinical translation of novel diagnostic and therapeutic tools, and curb the global spread of resistance."

Journal • Review

In Vitro Activity and In Vivo Efficacy in a Murine Model of Rezafungin, Anidulafungin, Caspofungin, and Micafungin Against the Fifth Clade of Candida (Candidozyma) auris. (PubMed, J Fungi (Basel)) - "Pseudohyphae production was common in controls, but not in echinocandin-treated mice. Rezafungin activity was comparable to or better than the three previously approved echinocandins."

Journal • Preclinical • Infectious Disease

Is there a role for rezafungin in intra-abdominal Candida spp. infections? A case series and literature review. (PubMed, J Mycol Med) - "Based on our experience, rezafungin may be considered for the treatment of IAC both as first-line and salvage therapy. Further studies and clinical trials are needed to confirm and support these findings."

Journal • Review • Candidiasis • Infectious Disease

Emerging antifungal agents in human medicine: Mechanisms, clinical progress, and future perspectives. (PubMed, Eur J Med Chem) - "This narrative review summarizes the current landscape of emerging antifungal therapies, focusing on ibrexafungerp 1, rezafungin 2, fosmanogepix 3, olorofim 4, opelconazole 5, and oteseconazole 6. However, important challenges remain, including limited activity against Mucorales for several agents, the potential emergence of future resistance, and the need for additional comparative clinical data and real-world experience. Overall, the expanding antifungal pipeline represents a major advancement toward more targeted and individualized antifungal therapy and may significantly reshape the future management of invasive and refractory fungal infections."

Journal • Review • Candidiasis • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Long-Term Use of Rezafungin: A Case Report and Insights Into Real-World Access. (PubMed, Transpl Infect Dis) - No abstract available

Journal • Real-world evidence

Candida auris: a review of global epidemiology, multidrug resistance, and infection control in healthcare-associated outbreaks. (PubMed, Front Cell Infect Microbiol) - "Analysis of 80 peer-reviewed studies reveals five principal findings: (1) C. auris exhibits clade-dependent geographic distribution and resistance profiles-Clade I (South Asia) and Clade III show fluconazole resistance exceeding 90%, whereas Clade IV exhibits 44% resistance; echinocandin resistance varies significantly by clade and no resistance was detected in certain clades; amphotericin B resistance varies from no detected resistance to 46% depending on clade; and pan-resistant strains have emerged; (2) biofilm-associated C. auris cells (sessile cells) exhibit MBECs 2- to 4,119-fold higher than planktonic MICs, representing a major driver of persistent colonization; (3) novel antifungal agents, including ibrexafungerp, manogepix (the active moiety of fosmanogepix), and rezafungin, demonstrate promising in vitro activity against C. auris, with manogepix showing the highest overall antibiofilm activity (geometric mean MBEC of 5.9 μg/mL) and ibrexafungerp demonstrating..."

Journal • Review • Infectious Disease

Brazilian guidelines for the diagnosis and treatment of candidemia and invasive candidiasis in adults and children. (PubMed, Braz J Infect Dis) - "This updated Brazilian guideline reflects current scientific evidence while addressing national healthcare realities, aiming to standardize care, improve outcomes, and reduce mortality associated with invasive candidiasis in Brazil."

Journal • Review • Candidiasis • Infectious Disease

Rezafungin Versus Caspofungin in Candidaemia and Invasive Candidiasis: A Post Hoc Pooled Analysis of Phase 2 and Phase 3 Trials. (PubMed, Mycoses) - P2, P3 | "This pooled analysis of Phase 2 and Phase 3 data, including the China extension cohort, supports the efficacy and safety of rezafungin. Rezafungin was non-inferior to caspofungin, with earlier mycological eradication."

Clinical • Journal • P2 data • P3 data • Retrospective data • Candidiasis

Rezafungin in the Management of Patients with Candida Osteoarticular Infections: Results from the REZ-GEIO project. (PubMed, Int J Antimicrob Agents) - "Rezafungin represents an effective and safe treatment for Candida spp. OAIs, especially for PJI, with no related microbiological failures or AEs."

Journal • Cardiovascular • Infectious Disease • Peripheral Arterial Disease

Literature review and case report on the use of rezafungin for spondylodiscitis in an outpatient parenteral antimicrobial therapy (OPAT) setting. (PubMed, J Bone Jt Infect) - "The reported use of antifungals in outpatient parenteral antimicrobial therapy (OPAT) for deep-seated bone and joint infections is limited. We report and discuss the use of rezafungin, a novel long-acting echinocandin, in an OPAT setting for spondylodiscitis secondary to Candida albicans."

Journal • Infectious Disease

Clinical controversies in the management of candidemia in adults and children. (PubMed, Am J Health Syst Pharm) - "Optimal candidemia management increasingly depends on individualized antifungal strategies, integration of RDTs and AFST, earlier species-directed therapy transitions, and selective evaluation for metastatic complications. Future studies are needed to better define uncomplicated candidemia, optimize treatment duration, and address evolving antifungal resistance."

Journal • Cardiovascular • Infectious Disease • Obesity • Ophthalmology

Rezafungin and catheter-related candidemia: a new player in a high-stakes game. (PubMed, Infez Med) - "Such an approach may facilitate earlier patient discharge, mitigate vascular-access issues, and support more efficient management of catheter-related candidemia. Larger, multicenter controlled studies are necessary to verify the clinical, economic, and sustainability benefits."

Journal • Infectious Disease

Wild-type MIC distributions and Epidemiological Cut-off Values for Ibrexafungerp, Manogepix, and Rezafungin against WHO Fungal Priority Pathogens. (PubMed, Int J Antimicrob Agents) - "For other WHO-listed pathogens, particularly filamentous and dimorphic fungi, data remained insufficient for robust analysis. The ECVs and T-ECVs derived herein provide crucial reference points to guide future resistance surveillance and inform the foundational epidemiology needed for clinical breakpoint setting."

Journal • Review

Candidozyma auris susceptibility from Michigan hospitals to manogepix, rezafungin and nine other antifungal agents. (PubMed, JAC Antimicrob Resist) - "MIC was determined by microdilution testing for amphotericin B, anidulafungin, caspofungin, manogepix, micafungin, rezafungin and five triazoles...The MIC90 demonstrated values of ≤0.5 mg/L for isavuconazole, itraconazole and posaconazole...Amphotericin B demonstrated greater activity compared with published studies. Fluconazole has poor activity; the activity of other triazoles remains unclear."

Journal • Infectious Disease

High and Sustained Release of the Novel Echinocandin Rezafungin from Bone Cement: An In Vitro Comparison with Liposomal Amphotericin B and Micafungin. (PubMed, J Arthroplasty) - "The REZA eluted from PMMA at high concentrations, releasing significantly more drug than MICA or AmB. Drug release was consistent with a concentration-dependent elution. All three antifungal agents retained metabolic activity, but REZA surpassed its MIC (C. albicans) by more than 10,000-fold, a margin that may translate into enhanced antibiofilm activity."

Journal • Preclinical • Infectious Disease

Intravitreal rezafungin and anidulafungin in a rabbit model of Aspergillus fumigatus endophthalmitis. (PubMed, Sci Rep) - "Rezafungin (RZF) and anidulafungin (AFG) are echinocandins with potential for treating Aspergillus fumigatus endophthalmitis. RZF and AFG showed low minimum effective concentrations, inhibited biofilm formation, disrupted fungal cell wall and membrane integrity in vitro and significantly reduced intraocular inflammation, fungal burden and aqueous humor TNF-α in vivo, with overall efficacy comparable to that of liposomal amphotericin B and voriconazole. These findings support RZF and AFG as promising alternative agents for intravitreal therapy of A. fumigatus endophthalmitis."

Journal • Preclinical • Infectious Disease • Inflammation • Ocular Infections • Ocular Inflammation • Ophthalmology • IL1B • TNFA

Rezafungin for Treatment of Chronic Pulmonary Aspergillosis (CPA) in Adults With Limited Treatment Options (clinicaltrials.gov) - P2 | N=60 | Active, not recruiting | Sponsor: Mundipharma Research Limited | Recruiting ➔ Active, not recruiting | Trial primary completion date: Jun 2026 ➔ Nov 2026

Enrollment closed • Trial primary completion date • Pulmonary Disease • Respiratory Diseases

ONCE-WEEKLY REZAFUNGIN AND ICU EFFICIENCY IN INVASIVE CANDIDIASIS: A RESOURCE UTILIZATION ANALYSIS IN THE BRAZILIAN SUPPLEMENTARY HEALTH SYSTEM (ISPOR 2026) - P2, P3 | "From the Brazilian supplementary payer perspective, rezafungin may significantly reduce ICU bed-days and infusion-related resource use in IC and candidemia, generating meaningful per-patient savings. Given comparable clinical efficacy across echinocandins, once-weekly rezafungin may support more efficient ICU resource allocation and inform decision-making in resource-constrained settings."

HEOR • Candidiasis • Infectious Disease