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]
^Strong N, Meeks G, Sheth SA, McCullough L, Villalba JA, Tan C, et al. (February 2024). "Neurovascular Complications of Iatrogenic Fusarium solani Meningitis". The New England Journal of Medicine. 390 (6): 522–529.
doi:
10.1056/NEJMoa2308192.
PMID38324485.
S2CID267547035.