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Dr. Grey AI

Peptide

Micafungin (Mycamine)

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.

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
1
Outcomes
10
Graded outcomes
4222

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

1 condition, plus general outcomes

Candidemia and Invasive Candidiasis

Candidemia and Invasive Candidiasis: outcomes studied for Micafungin (Mycamine)
GradeOutcomeEffectSizeStudiesPeopleStudies list
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.

Improves (the measure goes down)Large effect19 studies

Studies that measured hsct candida prophylaxis

and 9 more in the citations list

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.

Improves (the measure goes up)Moderate effect18 studies

Studies that measured invasive candidiasis/candidemia

and 8 more in the citations list

Esophageal Candidiasis

Clinical trials: Efficacy comparable to fluconazole in esophageal candidiasis treatment. FDA-approved indication. Endoscopic cure rates similar to standard therapy.

Improves (the measure goes up)Moderate effect15 studies

Studies that measured esophageal candidiasis

and 5 more in the citations list

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.

Improves (the measure goes up)Large effect9 studies

Studies that measured safety profile (pooled analysis)

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.

Improves (the measure goes up)Moderate effect12 studies

Studies that measured pediatric efficacy

and 2 more in the citations list

General

General: outcomes studied for Micafungin (Mycamine)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Antimicrobial Activity

14 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect12 studies

Studies that measured antimicrobial activity

and 2 more in the citations list

Liver Protection

4 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect8 studies

Studies that measured liver protection

Immune Function

3 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect7 studies

Studies that measured immune function

Pulmonary Function

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect6 studies

Studies that measured pulmonary function

Anti-Cancer Activity

2 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect6 studies

Studies that measured anti-cancer activity

Key findings

  • HSCT Candida ProphylaxisCandidemia and Invasive CandidiasisImproves (the measure goes down)
  • Invasive Candidiasis/CandidemiaCandidemia and Invasive CandidiasisImproves (the measure goes up)
  • Esophageal CandidiasisCandidemia and Invasive CandidiasisImproves (the measure goes up)

Studies cited

39 studies from PubMed

  1. Initial micafungin treatment does not improve outcomes compared to fluconazole treatment in immunocompromised and critically ill patients with candidaemia.The Journal of antimicrobial chemotherapy, 2024 · PMID 38831614
  2. Plasma Concentration of Antifungal Agent Micafungin for Pediatric Living Donor Liver Transplantation.Transplantation proceedings, 2024 · PMID 38326203
  3. Micafungin: A promising inhibitor of UBE2M in cancer cell growth suppression.European journal of medicinal chemistry, 2023 · PMID 37651876
  4. Risk assessment of micafungin-induced liver injury using spontaneous reporting system data and electronic medical records.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 2022 · PMID 35148944
  5. Nebulized Micafungin Treatment for Scopulariopsis/Microascus Tracheobronchitis in Lung Transplant Recipients.Antimicrobial agents and chemotherapy, 2021 · PMID 33722884
  6. Biological Properties and Analytical Methods for Micafungin: A Critical Review.Critical reviews in analytical chemistry, 2021 · PMID 32064916
  7. Micafungin as antifungal prophylaxis in non-transplanted haemotological patients.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia, 2020 · PMID 31865649
  8. Drug-Induced Liver Injury (DILI) With Micafungin: The Importance of Causality Assessment.The Annals of pharmacotherapy, 2020 · PMID 31786964
  9. Micafungin may be safely administered as outpatient parenteral antimicrobial therapy for chronic pulmonary aspergillosis.Mycoses, 2019 · PMID 30267594
  10. Immune neutropenia mediated by micafungin.American journal of hematology, 2019 · PMID 30945326
  11. Micafungin prophylaxis for acute leukemia patients undergoing induction chemotherapy.BMC cancer, 2019 · PMID 30991992
  12. Micafungin-Induced Hypoglycemia in a Patient With Type 1 Diabetes: A Case Report and Review of Literature.The Journal of clinical endocrinology and metabolism, 2019 · PMID 30398618
  13. Micafungin: prophylaxis and treatment in paediatric patientsMycoses, 2017 · PMID 28083856
  14. Micafungin as primary antifungal prophylaxis in patients presenting with acute myeloid leukemia.Medecine et maladies infectieuses, 2016 · PMID 27126350
  15. Empirical Micafungin Treatment and Survival Without Invasive Fungal Infection in Adults With ICU-Acquired Sepsis, Candida Colonization, and Multiple Organ Failure: The EMPIRICUS Randomized Clinical Trial.JAMA, 2016 · PMID 27706483
  16. Micafungin for Candida albicans pacemaker-associated endocarditis: a case report and review of the literature.Mycopathologia, 2013 · PMID 23073824
  17. Efficacy and safety of micafungin for invasive candida infections: a meta-analysis of randomized controlled trials.Chinese medical journal, 2012 · PMID 22340571
  18. Micafungin: a review of its use in the prophylaxis and treatment of invasive Candida infections.Drugs, 2012 · PMID 23083111
  19. Micafungin - the newest echinocandinPediatr Infect Dis J, 2011 · PMID 19856528
  20. Accumulated safety data of micafungin in therapy and prophylaxis in fungal diseasesExpert Opin Drug Saf, 2011 · PMID 21306282
  21. Safety of micafungin in infants: insights into optimal dosing.Expert opinion on drug safety, 2011 · PMID 21226655
  22. Safety of micafungin in pediatric clinical trials.The Pediatric infectious disease journal, 2011 · PMID 21378595
  23. Nebulizer delivery of micafungin aerosols.Pharmacotherapy, 2011 · PMID 21182358
  24. Micafungin-induced thrombotic thrombocytopenic purpura: a case report and review of the literature.American journal of therapeutics, 2011 · PMID 20335786
  25. Micafungin: a brief review of pharmacology, safety, and antifungal efficacy in pediatric patients.Pediatric blood & cancer, 2010 · PMID 20583216
  26. Efficacy and safety of micafungin as an empirical antifungal agent for febrile neutropenic patients with hematological diseases.Acta haematologica, 2010 · PMID 20664196
  27. [In vitro antifungal activity of micafungin].Revista iberoamericana de micologia, 2009 · PMID 19463275
  28. Antifungal activity of micafungin in serum.Antimicrobial agents and chemotherapy, 2009 · PMID 19687246
  29. Micafungin-induced immune hemolysis attacks.International journal of hematology, 2009 · PMID 19148589
  30. Micafungin: a review of its use in the prophylaxis and treatment of invasive Candida infections in pediatric patients.Paediatric drugs, 2009 · PMID 19566111
  31. Micafungin for the prophylaxis and treatment of Candida infectionsDrugs, 2008 · PMID 18380597
  32. Micafungin: a review of its use in adults for the treatment of invasive and oesophageal candidiasis, and as prophylaxis against Candida infections.Drugs, 2008 · PMID 18840009
  33. Micafungin sodium, the second of the echinocandin class of antifungals: theory and practiceAnn Pharmacother, 2007 · PMID 17661660
  34. Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasisClin Infect Dis, 2007 · PMID 17220753
  35. Role of micafungin in the antifungal armamentarium.Current medicinal chemistry, 2007 · PMID 17504145
  36. The echinocandin micafungin: a review of the pharmacology, spectrum of activity, clinical efficacy and safety.Expert opinion on pharmacotherapy, 2007 · PMID 17516879
  37. Micafungin: a new echinocandin antifungalClin Infect Dis, 2006 · PMID 17192162
  38. Micafungin versus fluconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantationClin Infect Dis, 2004 · PMID 17041612
  39. Micafungin: a therapeutic review.Expert review of anti-infective therapy, 2004 · PMID 15482200