Comparison of efficacy criteria across onychomycosis trials: need for standardization

Gupta, Aditya K.; Ryder, Jennifer E; Summerbell, Richard C.

doi:10.1046/j.1365-4362.2003.01678.x

Cited by 15 publications

(26 citation statements)

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“…In the absence of clear, consistent criteria in "total cure" rates, the different results observed prevent precise conclusions (15). These different parameters cause variations among different studies worldwide.…”

Section: Definition Of Cure (Clinical/mycological) Ratesmentioning

confidence: 98%

Update: medical treatment of onychomycosis

Shemer

2012

Dermatol Ther

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The diagnosis of onychomycosis should be made clinically and mycologically: clinically, by one of seven subtypes of onychomycosis, and mycologically, by evidence of dermatophytes or verified presence of molds and/or yeasts. Dermatophytes are usually considered as pathogens, whereas non-dermatophyte molds and yeasts are saprophytes. Basic anamnesis and close inspection should be performed to eliminate combined diseases (e.g., onychomycosis and trauma). The gold standard treatment for onychomycosis is basically systemic. Combination with topical agents, such as nail lacquer and/or chemical nail avulsion, produces better results than systemic treatment alone. Topical treatment as monotherapy is not efficient, excluding minor cases. Terbinafine is superior to itraconazole for dermatophyte onychomycosis. Evaluation of the outcome of clinical cure, mycological cure and total cure should be based on the well-defined worldwide criteria; otherwise, comparison of results is impossible due to lack of uniformity in different studies. In case of treatment failure, the reasons for each failure should be carefully considered.

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Section: Definition Of Cure (Clinical/mycological) Ratesmentioning

confidence: 98%

Update: medical treatment of onychomycosis

Shemer

2012

Dermatol Ther

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“…Although mycological cure in a target toenail usually corresponds with similar trends in the other nails, in some cases one or more of the other toenails will continue to show signs of infection. 13 …”

mentioning

confidence: 99%

Onychomycosis: Diagnosis and definition of cure

Scher

Tavakkol

Sigurgeirsson

et al. 2007

Journal of the American Academy of Dermatology

169

133

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“…Intermittent dosing of terbinafine appeared to produce good treatment results in some clinical trials. 9,10,[14][15][16] The present study was designed to consider the pharmacokinetic properties of terbinafine and the standard dose in Japan.…”

Section: Discussionmentioning

confidence: 99%

“…We assessed the efficacy of treatment at 12 months after initiation of treatment, or at 18 months after initiation of treatment in cases in which nail growth rate was slow. As shown by Gupta et al, 16 evaluation of drug efficacy is based on both clinical and mycological cure, requiring both clinical improvement and negative mycological culture plus negative microscopy. We defined patients as 'completely cured' when they achieved 100% regrowth of healthy nails.…”

Section: Discussionmentioning

confidence: 99%