Efficacy of 5% amorolfine nail lacquer in <i>Neoscytalidium dimidiatum</i> onychomycosis

Bunyaratavej, Sumanas; Leeyaphan, Charussri; Rujitharanawong, Chuda; Surawan, Theetat M.; Muanprasat, Chanai; Matthapan, Lalita

doi:10.3109/09546634.2015.1109029

Cited by 16 publications

(30 citation statements)

References 17 publications

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“…Chen et al reported a case report of a 16‐month‐old boy who had been successfully treated by 5% amorolfine nail lacquer after the diagnosis of onychomycosis, as systemic treatment with itraconazole and terbinafine in children is not approved by the Food and Drug Administration (FDA) (Chen et al, ). Amorolfine nail lacquer as a novel monotherapy regimen in the treatment of Neoscytalidium onychomycosis which is considered recalcitrant could also provide superior efficacy than topical urea cream with occlusion in every aspect (Bunyaratavej et al, ). Urea ointment under occlusion is applied as atraumatic chemomechanical maceration of the diseased nail, however, the clinical success of it alone is poor, better cure rates can be found with the combination of antifungal agent and nail removal, such as the combination of bifonazole 1% and urea ointment 40%, the efficacy of which is slightly lower than that of amorolfine 5% lacquer (Niewerth & Korting, ).…”

Section: Discussionmentioning

confidence: 99%

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

Feng

Xiong

Ran

2017

Dermatologic Therapy

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The efficacy and safety of amorolfine 5% nail lacquer in combination with systemic antifungal agents in the treatment of the onychomycosis were evaluated. According to our meta-analysis, combination treatment of amorolfine 5% nail lacquer and systemic antifungals can result in higher percentage of complete clearance of onychomycosis. It showed that the experimental combination group was more effective than monotherapy of the systemic antifungals [OR (odds ratio) = 1.97, 95%CI (95% confidence interval) = 1.44-2.69], and no more adverse events happened with the addition of amorolfine 5% nail lacquer (OR = .96, 95%CI = .56-1.63, p = .95). This effect strengthens the fact that amorolfine 5% nail lacquer in combination with systemic antifungal agents was better than the monotherapy of systemic antifungals like itraconazole and terbinafine.

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Section: Discussionmentioning

confidence: 99%

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

Feng

Xiong

Ran

2017

Dermatologic Therapy

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“…onychomycosis at 12 months and 89.3% mycological cure with 5% amorolfine nail lacquer in N. dimidiatum onychomycosis. 25,26 In the latter study, a mycological cure of 32% was noted in those patients marginally higher mycological cure rate of 65% as compared to 60% in those using 5% amorolfine nail lacquer alone. 27 Amphotericin B has excellent in vitro activity against nondermatophyte molds.…”

Section: Discussionmentioning

confidence: 82%

Effectiveness and safety of topical amphotericin B in 30% dimethyl sulfoxide cream versus 30% dimethyl sulfoxide cream for nondermatophyte onychomycosis treatment: A pilot study

Leeyaphan¹,

Suiwongsa

Komesmuneeborirak

et al. 2021

IJDVL

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Background: Although topical amphotericin B cream is effective for the treatment of nondermatophyte mold onychomycosis in vitro, studies of its effectiveness and safety in vivo are limited. Objectives: We studied the effectiveness and safety of topical 0.3% amphotericin B in 30% dimethyl sulfoxide cream (amphotericin B cream) in nondermatophyte mold onychomycosis using the vehicle cream 30% dimethyl sulfoxide cream as control. Methods: This randomized controlled study was conducted between January 2019 and November 2020. Patients diagnosed with nondermatophyte mold onychomycosis were randomly divided into two groups of ten patients each: one treated with amphotericin B cream and the other with the vehicle cream. Clinical and mycological cure as well as safety were evaluated. Results: Ten patients each treated with amphotericin B cream and the vehicle cream were included in the study, but only nine patients in the vehicle cream group were available for follow up. All the 19 evaluable patients had distal lateral subungual onychomycosis and the great toenails were affected in 18 (94.7%) of these. Mycological cure was achieved in 8 (80%) patients treated with amphotericin B cream and in 4 (44.4%) patients using the control (vehicle) cream. Clinical cure was achieved in 7 (70%) patients treated with amphotericin B cream, but only in 2 (22.2%) patients on the control cream. No adverse events were observed. Limitations: The small sample size and the fact that PCR fungal identification that provides accurate identification of fungal species was not performed are limitations of our study. Conclusion: Topical amphotericin B cream was both very effective and safe in the treatment nondermatophyte mold onychomycosis. The control (vehicle) cream containing 30% dimethyl sulfoxide also demonstrated some antifungal activity.

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“…Complete cure, as a combination of clinical and mycological cure, being the most desired outcome clinically was reported by two studies [31, 32]. A complete cure was reported in 27.7% [31] and 20% [32] in urea group compared to 20.8% in urea-bifonazole and 50% in amorolfine group, respectively.…”

Section: Resultsmentioning

confidence: 98%

The use of urea for the treatment of onychomycosis: a systematic review

Dars

Banwell

Matricciani

2019

Journal of Foot and Ankle Research

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Background Onychomycosis, a fungal infection affecting the nail plate, is a common condition often requiring prolonged treatment regimens, with low success rates. Urea is one treatment option, which is thought to improve the efficacy of topical and oral antifungal agents. Despite a theoretical basis for the use of urea for the treatment of onychomycosis, the evidence-base for this treatment has not been systematically reviewed. Aim The purpose of this study was to conduct a systematic literature review to determine the efficacy and safety of urea as a monotherapy and as adjunct therapy, compared to other treatment regimens for onychomycosis. Method A systematic literature search of ten electronic databases was conducted. Only studies that used microscopy and culture or other validated laboratory-based testing method to confirm the presence of a fungal infection before treatment were included. The outcome measures assessed were efficacy (defined in terms of mycological, clinical and complete cure) and safety (defined as self-reported adverse events). Results The systematic search yielded 560 unique studies for review. Of these, only six were eligible for inclusion. All studies were observed to have methodological concerns, most studies consisted of small sample sizes and were difficult to compare given heterogeneity in outcome measures and follow-up time. Despite this, a trend was observed to suggest that urea, when added to topical or oral antifungal treatment regimens, improved efficacy of the treatment. Conclusion This review suggests that topical urea, as an adjunct to topical and oral antifungal treatment regimens, may improve the efficacy of treatment. However, further research is needed. Electronic supplementary material The online version of this article (10.1186/s13047-019-0332-3) contains supplementary material, which is available to authorized users.

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Efficacy of 5% amorolfine nail lacquer in Neoscytalidium dimidiatum onychomycosis

Abstract: This study supported that amorolfine nail lacquer provided promising efficacy in the treatment of Neoscytalidium onychomycosis as a novel monotherapy regimen which were superior to topical urea cream with occlusion in every aspect.

Cited by 16 publications

References 17 publications

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

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

Effectiveness and safety of topical amphotericin B in 30% dimethyl sulfoxide cream versus 30% dimethyl sulfoxide cream for nondermatophyte onychomycosis treatment: A pilot study

The use of urea for the treatment of onychomycosis: a systematic review

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