Fosmanogepix

Fosmanogepix is an experimental antifungal drug being developed by Amplyx Pharmaceuticals (now currently by Pfizer and Basilea^[1][2]) It is being investigated for its potential to treat various fungal infections including aspergillosis, candidaemia, and coccidioidomycosis.^[3]

Fosmanogepix

Clinical data
Other names	APX001, APX-001
ATC code	None
Legal status
Legal status	Investigational
Identifiers
IUPAC name [2-Amino-3-(3-{4-[(2-pyridinyloxy)methyl]benzyl}-1,2-oxazol-5-yl)-1-pyridiniumyl]methyl hydrogen phosphate
CAS Number	2091769-17-2
PubChem CID	44123754
DrugBank	15183
ChemSpider	64853722
UNII	1XQ871489P
KEGG	D11694
Chemical and physical data
Formula	C22H21N4O6P
Molar mass	468.406 g·mol−1
3D model (JSmol)	Interactive image
SMILES c1ccnc(c1)OCc2ccc(cc2)Cc3cc(on3)c4ccc[n+](c4N)COP(=O)(O)[O-]
InChI InChI=1S/C22H21N4O6P/c23-22-19(4-3-11-26(22)15-31-33(27,28)29)20-13-18(25-32-20)12-16-6-8-17(9-7-16)14-30-21-5-1-2-10-24-21/h1-11,13,23H,12,14-15H2,(H2,27,28,29) Key:JQONJQKKVAHONF-UHFFFAOYSA-N

Fosmanogepix is a prodrug and is converted into the active drug form, manogepix in vivo.^[4] Manogepix targets the enzyme GWT1 (Glycosylphosphatidylinositol-anchored Wall protein Transfer 1^[5]), an enzyme in the glycosylphosphatidylinositol biosynthesis pathway.^[6] Inhibiting this enzyme prevents the fungi from properly modifying certain (so called GPI-anchored) proteins essential to the fungal life cycle. This mechanism of action is totally novel; therefore, if approved, fosmanogepix would become a first-in-class medication.^[6][7]

In 2023, the drug was given a compassionate use authorization for four patients with Fusarium solani meningitis.^[8]