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Micafungin (Mycamine)

Peptide

Micafungin is a cyclic lipopeptide echinocandin antifungal. FDA-approved 2005 for esophageal candidiasis, invasive candidiasis/candidemia, and uniquely for Candida prophylaxis in HSCT recipients. Clinical trials (n=3028 pooled): Favorable safety profile. Superior to fluconazole for HSCT prophylaxis. Fungicidal against Candida including fluconazole-resistant strains. Second echinocandin approved in US after caspofungin.

Quick Answer

What it is

Micafungin is a cyclic lipopeptide echinocandin antifungal. FDA-approved 2005 for esophageal candidiasis, invasive candidiasis/candidemia, and uniquely for Candida prophylaxis in HSCT recipients.

Key findings

  • Grade A: HSCT Candida Prophylaxis (Candidemia and Invasive Candidiasis)
  • Grade A: Esophageal Candidiasis (Candidemia and Invasive Candidiasis)
  • Grade A: Invasive Candidiasis/Candidemia (Candidemia and Invasive Candidiasis)

Safety

No specific caution or interaction language was detected in the current summary/outcome notes.

⚠️ Research Notice

This peptide information is for educational and research purposes only. Peptides may not be FDA-approved for human use and may only be legally available for research purposes. Consult qualified healthcare professionals before considering any peptide compounds.

ℹ️ Quick Facts: Micafungin (Mycamine)

Quick Facts: Micafungin (Mycamine)

  • Best Evidence:Grade A
  • Conditions Studied:1
  • Research Outcomes:10
  • Grade A Findings:4
  • Grade B Findings:2
  • Key Effect:Candidemia and Invasive Candidiasis
A4
B2
C2
D2
1 conditions · 10 outcomes

Detailed Outcomes

A
HSCT Candida Prophylaxis
Phase 3 RCT: Micafungin superior to fluconazole for prophylaxis of invasive Candida infections in HSCT recipients. Only echinocandin FDA-approved for this indication. Significantly reduced breakthrough fungal infections.
large↓Improves
A
Esophageal Candidiasis
Clinical trials: Efficacy comparable to fluconazole in esophageal candidiasis treatment. FDA-approved indication. Endoscopic cure rates similar to standard therapy.
moderate↑Improves
A
Invasive Candidiasis/Candidemia
Phase 3 trials: Excellent clinical and microbiological efficacy in primary treatment of invasive candidiasis. Comparable to caspofungin and liposomal amphotericin B. FDA-approved for candidemia.
moderate↑Improves
A
Safety Profile (Pooled Analysis)
Pooled analysis of 17 trials (n=3028): Favorable clinical safety profile similar to other echinocandins. Well tolerated across treatment and prophylaxis indications. Low discontinuation rates.
large↑Improves
B
Pediatric Efficacy
Approved for pediatric use. Effective for prophylaxis and treatment in children including neonates. Weight-based dosing (2-4 mg/kg). Scientific evidence supports safety and efficacy in pediatric populations.
moderate↑Improves
B
Antimicrobial Activity
14 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.
moderate↑Improves
C
Liver Protection
4 preclinical studies support this finding. Primarily preclinical evidence.
small↑Improves
C
Immune Function
3 human trials support this finding. Human clinical trial data available.
small↑Improves
D
Pulmonary Function
2 preclinical studies support this finding. Primarily preclinical evidence.
small↑Improves
D
Anti-Cancer Activity
2 human trials support this finding. Human clinical trial data available.
small↑Improves

Research Citations (39)

Initial micafungin treatment does not improve outcomes compared to fluconazole treatment in immunocompromised and critically ill patients with candidaemia.
(2024)
PMID: 38831614
Plasma Concentration of Antifungal Agent Micafungin for Pediatric Living Donor Liver Transplantation.
(2024)
PMID: 38326203
Micafungin: A promising inhibitor of UBE2M in cancer cell growth suppression.
(2023)
PMID: 37651876
Risk assessment of micafungin-induced liver injury using spontaneous reporting system data and electronic medical records.
(2022)
PMID: 35148944
Nebulized Micafungin Treatment for Scopulariopsis/Microascus Tracheobronchitis in Lung Transplant Recipients.
(2021)
PMID: 33722884
Biological Properties and Analytical Methods for Micafungin: A Critical Review.
(2021)
PMID: 32064916
Micafungin as antifungal prophylaxis in non-transplanted haemotological patients.
(2020)
PMID: 31865649
Drug-Induced Liver Injury (DILI) With Micafungin: The Importance of Causality Assessment.
(2020)
PMID: 31786964
Micafungin may be safely administered as outpatient parenteral antimicrobial therapy for chronic pulmonary aspergillosis.
(2019)
PMID: 30267594
Immune neutropenia mediated by micafungin.
(2019)
PMID: 30945326

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1 shared condition · 6 outcomes

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Caspofungin (Cancidas)

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1 shared condition · 10 outcomes

Caspofungin is a cyclic lipopeptide echinocandin - the first in its class FDA-approved (2001). Indicated for invasive candidiasis, candidemia, esophageal candidiasis, and invasive aspergillosis. Phase 2/3 trials: 85% response in esophageal candidiasis vs 67% amphotericin B. Active against fluconazole-resistant Candida (MIC90 0.5-1 ug/ml for 157 resistant isolates). Safe profile with only 2% discontinuation in RCTs. Standard comparator for newer echinocandins.

Anidulafungin

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1 shared condition · 6 outcomes

Anidulafungin is a cyclic lipopeptide echinocandin antifungal for invasive candidiasis and candidemia. FDA-approved 2006. A-GRADE evidence: Phase 3 trial showed 76% success vs 60% fluconazole (P=0.01). Potent activity against Candida albicans, C. glabrata, C. tropicalis, C. krusei (MIC90 0.06-0.12 ÎĽg/ml). Crucially, 99% of fluconazole-resistant isolates remain susceptible. No hepatic or renal dose adjustment needed due to non-CYP450 metabolism - advantageous in critically ill patients. PRESCRIPTION ONLY - IV administration.