Efficacy and tolerability of amorolfine 5% nail lacquer in combination with systemic antifungal agents for onychomycosis: A meta-analysis and systematic review

Feng, Xiaowei; Xiong, Xincai; Ran, Yuping

doi:10.1111/dth.12457

Cited by 27 publications

(14 citation statements)

References 37 publications

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“…Topical antifungal therapy is a therapeutic option when oral antifungal agents are contraindicated or cannot be tolerated [ 1 , 2 , 44 , 45 , 88 ]. Topical antifungals may also be used in combination with oral antifungal therapy as an adjunctive therapy to increase the cure rate due to synergistic antifungal action of the drugs [ 32 , 88 , 105 , 113 ]. Because the rate of nail growth is faster and the nail plate is thinner in children, children are more likely to respond to topical antifungal therapy better than adults [ 17 , 53 , 88 , 114 , 115 ].…”

Section: Treatmentmentioning

confidence: 99%

Onychomycosis: An Updated Review

Leung

Lam

Leung

et al. 2020

IAD

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Background : Onychomycosis is a common fungal infection of the nail. Objective: The study aimed to provide an update on the evaluation, diagnosis, and treatment of onychomycosis. Methods: A PubMed search was completed in Clinical Queries using the key term “onychomycosis”. The search was conducted in May 2019. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 20 years. The search was restricted to English literature. Patents were searched using the key term “onychomycosis” in www.freepatentsonline.com. Results : Onychomycosis is a fungal infection of the nail unit. Approximately 90% of toenail and 75% of fingernail onychomycosis are caused by dermatophytes, notably Trichophyton mentagrophytes and Trichophyton rubrum. Clinical manifestations include discoloration of the nail, subungual hyperkeratosis, onycholysis, and onychauxis. The diagnosis can be confirmed by direct microscopic examination with a potassium hydroxide wet-mount preparation, histopathologic examination of the trimmed affected nail plate with a periodic-acid-Schiff stain, fungal culture, or polymerase chain reaction assays. Laboratory confirmation of onychomycosis before beginning a treatment regimen should be considered. Currently, oral terbinafine is the treatment of choice, followed by oral itraconazole. In general, topical monotherapy can be considered for mild to moderate onychomycosis and is a therapeutic option when oral antifungal agents are contraindicated or cannot be tolerated. Recent patents related to the management of onychomycosis are also discussed. Conclusion: Oral antifungal therapies are effective, but significant adverse effects limit their use. Although topical antifungal therapies have minimal adverse events, they are less effective than oral antifungal therapies, due to poor nail penetration. Therefore, there is a need for exploring more effective and/or alternative treatment modalities for the treatment of onychomycosis which are safer and more effective.

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Section: Treatmentmentioning

confidence: 99%

Onychomycosis: An Updated Review

Leung

Lam

Leung

et al. 2020

IAD

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“…Feng et al 45 performed a meta‐analysis on the efficacy of amorolfine 5% nail lacquer in combination with systemic antifungal agents. Accordingly, amorolfine combination treatment results in a significantly higher rate of complete clearance of onychomycosis than systemic monotherapy with itraconazole or terbinafine (odds ratio = 1.97; 95% confidence interval = 1.44‐2.69).…”

Section: Resultsmentioning

confidence: 99%

Non‐dermatophyte fungi in onychomycosis—Epidemiology and consequences for clinical practice

Reinel

2021

Mycoses

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Onychomycoses are difficult‐to‐treat fungal infections with a high recurrence rate that relates to the anatomic and pathophysiological conditions in the nail organ and the required extended duration of treatment. Clinical‐epidemiological studies demonstrated that non‐dermatophyte molds and yeasts are the primary causative agents in 20%–30% of onychomycoses. Mixed infections with dermatophytes are observed as well. Therefore, the causative agents should be determined by fungal culture and the antifungal treatment regimen should reliably cover non‐dermatophytes, if appropriate. Systemic‐topical combination therapy involving a broad‐spectrum, locally applied antifungal may increase the mycological and clinical cure rates compared to monotherapy with systemic drugs.

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“…Classical treatments with azoles or terbinafine are mostly effective for DMPs . Once an oral antifungal drug is administered, DMPs, which usually respond to oral antifungal monotherapy, are nearly wholly eradicated.…”

Section: Baseline Characteristics Of Patients With Pure Dermatophyte mentioning

confidence: 99%

Eclipsed phenomenon: the relationship between nail and foot infections in patients presenting with nondermatophyte infections after dermatophyte infections in onychomycosis

et al. 2020

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Efficacy and tolerability of amorolfine 5% nail lacquer in combination with systemic antifungal agents for onychomycosis: A meta-analysis and systematic review

Cited by 27 publications

References 37 publications

Onychomycosis: An Updated Review

Onychomycosis: An Updated Review

Non‐dermatophyte fungi in onychomycosis—Epidemiology and consequences for clinical practice

Eclipsed phenomenon: the relationship between nail and foot infections in patients presenting with nondermatophyte infections after dermatophyte infections in onychomycosis

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