An open randomized comparative study to test the efficacy and safety of oral terbinafine pulse as a monotherapy and in combination with topical ciclopirox olamine 8% or topical amorolfine hydrochloride 5% in the treatment of onychomycosis

Jaiswal, Amit; Sharma, Roopali; Garg, Ashok

doi:10.4103/0378-6323.37056

Cited by 39 publications

(2 citation statements)

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“…31 On the other hand, a treatment regimen of oral terbinafine combined with topical ciclopirox resulted in an increase in mycologic cure compared to terbinafine alone. [32][33][34] Mycologic cure rates between 53 and 87% were obtained with efinaconazole 10% nail solution. 8,35 The mycologic cure rates reported for the treatment of NDM onychomycosis varied from one species to another and are limited by small sample sizes, with terbinafine reporting the highest cure rates.…”

Section: Treatment Choice Based On the Infectious Organism(s)mentioning

confidence: 99%

Management of Onychomycosis in Canada in 2014

Gupta

Paquet

2015

J Cutan Med Surg

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Several options are available: terbinafine, itraconazole, fluconazole, ciclopirox 8% nail lacquer, efinaconazole 10% nail solution, and laser therapy. Further studies on lasers are needed before use can be recommended. Nondermatophyte molds or mixed infection can be managed with terbinafine or itraconazole with or without topicals. Itraconazole, fluconazole, and efinaconazole can be used for Candida infection. For dermatophytes, topicals can be considered for mild to moderate onychomycosis. For moderate to severe cases, any oral monotherapy can be used; however, we suggest terbinafine if there is a possibility of a drug interaction. These recommendations can be applied for all ages, immune function, or metabolic status, but proper monitoring and contraindications should be taken into consideration.

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Section: Treatment Choice Based On the Infectious Organism(s)mentioning

confidence: 99%

Management of Onychomycosis in Canada in 2014

Gupta

Paquet

2015

J Cutan Med Surg

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“…Whereas mild cases (<30% diseased nail) of onychomycosis may not benefit significantly more from combination treatment, evidence suggests that moderate to severe cases of onychomycosis, or cases with traditionally difficult-to-treat features (e.g., dermatophytoma, onycholysis), could benefit from combination treatment [4,5,6]. Combination therapies that have shown efficacy in treating onychomycosis include oral terbinafine with topical amorolfine [5,6] or ciclopirox [6,7], and itraconazole with amorolfine [8]. …”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study Comparing K101 Nail Solution as a Monotherapy and in Combination with Oral Terbinafine or Itraconazole for the Treatment of Toenail Onychomycosis

Shemer

Gupta

Babaev

et al. 2017

Skin Appendage Disord

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Background: Onychomycosis is a difficult-to-treat fungal infection of the nails. The efficacy of monotherapy is not ideal, and combination therapies provide an alternative that may increase treatment efficacy. Method: A retrospective analysis of data from 91 patients was undertaken. Treatment for toenail onychomycosis occurred between 2014 and 2016 and consisted of combination therapy with oral terbinafine (250 mg/day for 12 weeks) or itraconazole (3 pulses, 400 mg/day for 7 days) + K101 nail solution daily, or K101 nail solution monotherapy. Efficacy outcomes at 12 and 15 months were analyzed. Results: At 12 months, the clinical cure rate for combination of terbinafine + K101 solution was significantly higher than that for K101 monotherapy (p = 0.008). Patients receiving this combination also showed significant improvement in percent of affected nail at 3 months (p = 0.029), while patients receiving itraconazole + K101 solution demonstrated improvement in percent of affected nail at 6 months (p = 0.037). At 15 months, there was no significant difference between treatments for complete, clinical, and mycological cure. Conclusion: Combination therapy with oral terbinafine or itraconazole and K101 nail solution results in clearance of infected nail earlier than that with topical K101 alone. These combinations may encourage compliance and be effective for patients with moderate onychomycosis.

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Antifungal Drugs

Seyedmousavi

2021

Burger's Medicinal Chemistry and Drug Discovery

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Invasive fungal infections are considered an expanding public health threat, worldwide. Annually, over one billion people are estimated to suffer from fungal infections and/or allergies originating from opportunistic and pathogenic fungi. Fungal diseases also kill more than 1.5 million each year. Antifungal therapy is a central component in the management of life‐threatening fungal infections. However, only few classes of FDA‐approved antifungal agents are available for therapy, which have limited efficacy, particularly in the treatment of disseminated and emerging fungal infections. These drugs include polyenes, azoles, echinocandins, and the nucleoside analogs. Depending on the strategy chosen, monotherapy and/or combination antifungal drugs can be used based on the clinical picture and the species identification of the etiologic agent. The use of antifungal drugs in the therapy of fungal diseases can lead to the development of resistance. Of note, some organisms are inherently resistant to these antifungal agents. This chapter focuses on the currently available classes of systemic antifungal drugs in clinical use, innovative strategies in reformulation and delivery of available drugs, development of new agents of known antifungal drug classes, and new drugs of synthetic antifungal drugs under preclinical and clinical investigations. We further discuss the currently available evidence for the emergence of fungal resistance against these agents.

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An open randomized comparative study to test the efficacy and safety of oral terbinafine pulse as a monotherapy and in combination with topical ciclopirox olamine 8% or topical amorolfine hydrochloride 5% in the treatment of onychomycosis

Abstract: Terbinafine pulse therapy is effective and safe alternative in treatment of onychomycosis due to dermatophytes; and combination therapy with topical ciclopirox or amorolfine do not show any significant difference in efficacy in comparison to monotherapy with oral terbinafine.

Cited by 39 publications

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Management of Onychomycosis in Canada in 2014

Management of Onychomycosis in Canada in 2014

A Retrospective Study Comparing K101 Nail Solution as a Monotherapy and in Combination with Oral Terbinafine or Itraconazole for the Treatment of Toenail Onychomycosis

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