Analyzing US FDA-Approved Infectious Disease Drugs from 2015-2023

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2024-11-22

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Primary Author: Rizamari May Pascua Co-Authors: Tracy Pham, Dianqing Sun, PhD Presentation Title: Analyzing US FDA-Approved Infectious Disease Drugs from 2015-2023 Purpose: In 2019, there are approximately 10.2 million hospital visits for infectious and parasitic diseases in the US. Because of emerging multi-drug resistance and public health threats, new drugs are urgently needed to combat problematic bacterial, viral, fungal, and parasitic infections. The US Food and Drug Administration (FDA) approved drugs play a crucial role in enhancing optimal patient care, improving clinical outcome, and broadening treatment options. The objective of this study is to review all US FDA approved infectious disease (ID) agents from 2015-2023 and analyze their medicinal chemistry properties, mechanism of action, pharmacokinetic (PK) profiles, and clinical applications. Methods: This study utilized prescribing information and online open resources provided by the US FDA’s Center for Drug Evaluation and Research (CDER). Drug information resources such as Lexicomp and Sanford guide were searched for the dosing, route of administration, PK parameters, and indication of the infectious disease medications. Physicochemical properties and Lipinski’s Rule of 5 such as molecular weight, hydrogen bond donor, hydrogen bond acceptor, logP were obtained from ChemSpider & Scifinder databases and subsequently analyzed to evaluate the oral bioavailability of these infectious disease drugs and rationalize their routes of administration and clinical applications. Results: Based on the data collected from 2015-2023, the US FDA has approved a total of 49 novel infectious disease agents including antiviral, antibacterial, antifungal, and antiparasitic. Specifically, 21 antiviral agents were approved to address a wide spectrum of viral conditions, including 7 for human immunodeficiency virus (HIV), 6 for hepatitis C virus (HCV), 2 for SARS-CoV-2, 2 for ebola virus, 1 for respiratory syncytial virus (RSV), 1 for influenza virus, 1 for cytomegalovirus (CMV), and 1 for smallpox virus. Additionally, 18 new antibacterial agents approved include 2 new chemotypes (cephalosporin-siderophore conjugate antibiotic and anti-tuberculosis agent nitroimidazooxazine), 1 nitroimidazole, 2 fluoroquinolones, 1 rifamycin, 3 tetracyclines, 1 pleuromutilin, 1 aminoglycoside, 5 combination therapy (e.g., beta-lactam/beta-lactamase inhibitor), along with 2 biologic monoclonal antibodies (mAbs). Furthermore, 6 antiparasitic agents and 4 antifungal agents have also been approved since 2015. Notably, several of these agents have been subsequently discontinued from the US market due to commercial and/or practice change reasons. Each of these agents will be comprehensively discussed including chemical class, physicochemical property, mechanism of action, route of administration, and dosing regimen. Further, detailed insights into their PK profiles (e.g., Tmax, half-life, bioavailability, protein binding, metabolism, and excretion) will also be presented. Conclusion: Given rising (multi)drug-resistant microorganisms and evolving public health threats, there is an urgent, unmet clinical need for developing new infectious disease drugs with novel mechanism of action. Since 2015, significant new medicine advances have been made in this field, leading to the US FDA approval of 49 new chemical entity ID drugs. Thus, it is imperative for pharmacists, as drug and pharmacotherapy experts, along with other healthcare professionals, to stay updated regarding these new medication therapies, evaluate these expanded treatment options and provide optimal patient care.

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http://rightsstatements.org/vocab/InC-EDU/1.0/

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UH Hilo DKICP

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