For many years, doctors have relied on the same small group of antifungal drugs — mainly azoles (like itraconazole and voriconazole), amphotericin, and echinocandins. These have saved lives, but some fungi are becoming resistant, and some people can’t tolerate them because of side-effects or drug interactions.
Two completely new antifungal medicines — Olorofim and Fosmanogepix — are now in the final stages of research. They work in new ways and could help patients whose infections no longer respond to current treatments.
🧬 Olorofim (by F2G Ltd, UK)
How it works:
Olorofim blocks a vital process that fungi need to make DNA. It belongs to a brand-new group called orotomides, and works very differently from other antifungals.
Which infections it targets first:
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The first planned use will be for people with invasive mould infections (for example, Aspergillus fumigatus and some rare moulds) when existing medicines don’t work or can’t be used.
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It is especially promising for azole-resistant Aspergillus, which is becoming more common.
How it might help in the future:
Although early studies are focused on severe infections in people with weak immune systems, Olorofim has also shown good results in some patients with chronic pulmonary aspergillosis (CPA) who could not take azoles.
Once it is licensed, hospitals such as the National Aspergillosis Centre may be able to use it for difficult or resistant cases of CPA on a specialist-approval basis.
When it might be available:
F2G has completed late-stage studies and is preparing for regulatory approval.
If all goes well, Olorofim could be available around 2026–2027 in some countries, with the UK likely to follow once it is approved and adopted by the NHS.
⚗️ Fosmanogepix (by Basilea and Pfizer)
How it works:
Fosmanogepix (converted in the body to manogepix) blocks the fungus from making a protective coating around its cell surface. This prevents it from growing and spreading. It belongs to another new group of antifungal drugs.
Which infections it targets first:
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The first major study is for Candida bloodstream infections (candidemia) and other serious yeast infections.
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A second study focuses on invasive mould infections, including aspergillosis, in patients with few treatment options.
How it might help in the future:
Once approved for invasive infections, Fosmanogepix could later be tested in longer-term or chronic lung infections, such as CPA, if it proves safe for long-term use.
When it might be available:
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The first approval (for Candida) may come around 2027.
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The aspergillosis trial is still running and not expected to finish before 2028–2029, so that indication will follow later.
🩺 What This Means for People with Aspergillosis
| Drug | New or existing? | First use likely for | Could later help with | When available (approx.) |
|---|---|---|---|---|
| Olorofim | New class (orotomide) | Invasive Aspergillus and resistant moulds | Difficult or resistant cases of chronic pulmonary aspergillosis (CPA) | 2026–2027 |
| Fosmanogepix | New class (Gwt1 inhibitor) | Candida bloodstream infections | Invasive mould infections, possibly CPA later | 2027–2029 |
🧩 In summary
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These two drugs represent the first completely new antifungal classes in decades.
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They are being tested mainly for life-threatening fungal infections where current medicines fail.
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Once approved, they may offer new options for people with resistant or difficult-to-treat forms of aspergillosis, including some patients with CPA.
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They are not yet available on prescription, but progress looks very promising.
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