An innovative polysaccharide nanobased nail formulation for improvement of onychomycosis treatment

Lam

et al. 2020

IAD

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.

Section: Current and Future Developmentsmentioning

confidence: 99%

Section: Current and Future Developmentsmentioning

confidence: 99%

Onychomycosis: An Updated Review

Lam

et al. 2020

IAD

“…The nano-formulations are advantageous for topical delivery because they ensure stability of actives and act as reservoirs for extended drug delivery. Nanocapsules were composed of pullulan, a water-soluble polysaccharide that forms films 44 . The newer film-forming formula provided the best efficiency of ex vivo delivery, and drug payload percentages were higher than those of marketed products.…”

Section: Physical Strategies and Laser Therapiesmentioning

confidence: 99%

Recent advances in therapies for onychomycosis and its management

Gupta

Stec

2019

F1000Res

Onychomycosis is the most common affliction of the nail. It may be caused by dermatophytes, yeasts, and non-dermatophyte molds. Traditionally, oral antifungal treatments have been used to treat the fungus, although they can be accompanied by side effects and drug interactions. Topical treatments provide an alternative modality, bypassing the systemic effects of oral drugs; recent research has centered on topical drug improvement and development. Physical and laser treatments are being used in conjunction with topicals, which may help penetrate the thick nail plate. In this review, techniques from all categories are outlined: both novel experimental approaches and progress and effectiveness of recently developed treatments. More long-term studies are required to determine the efficacy of various treatments, but cure rates are improved when patients adhere to treatments and follow preventative measures to avoid disease recurrence.

“…The nanocapsule suspensions and Pullulan nanobased nail formulation also demonstrated lesser irritancy than free drugs and commercial formulations. Pullulan nano-based nail formulation was found promising for the treatment of onychomycosis [9]. This work has been further extended to the addition of in vitro release tests [IVRT] and in vitro permeation tests [IVPT].…”

Section: Novel Drug Delivery Strategies For Treating Onychomycosismentioning

confidence: 99%

“…Such novel systems delivered through an appropriate dosage form will serve as useful vehicles for nail drug delivery. This review will focus on discussing such novel strategies which hold a lot of potential for treating persistent issue like onychomycosis [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Novel Drug Delivery Strategies for the Treatment of Onychomycosis

Dhamoon

Popli

Gupta

2019

PNT

Onychomycosis accounts for 50% of all nail disease cases and is commonly caused by dermatophytes. It was primarily considered a cosmetic problem but has been garnering attention lately due to its persistent nature and difficult treatment with relapses. With prolonged treatment duration and high cost involved in treating onychomycosis, several attempts have been made in overcoming the rigid nail barrier. The conventional treatment of onychomycosis involves oral and topical therapy. The oral antifungal agents though quite effective, are hepato-toxic and cause drug-drug interactions. Topical therapy is more patient compliant being devoid of such adverse effects but it suffers from another setback of improper nail penetration. Amorolfine and ciclopirox nail lacquers are popular market products. Since decades, efforts have been made to enhance topical delivery for efficiently treating onychomycosis. Mechanical, physical and chemical methods have been employed. Despite all the attempts made, the nail delivery issues are far from being solved. Recently, the focus has shifted to novel drug delivery systems like nanoparticles, microemulsions, polymeric films and nail lacquers for enhanced drug permeation and localized therapy. The research around the world is exploring their potential as effective treatment options. This review intends to further explore the novel delivery strategies to treat a persistent fungal infection like onychomycosis.