Efinaconazole Topical Solution, 10%: Efficacy in Patients with Onychomycosis and Coexisting Tinea Pedis

Markinson, Bryan C.; Caldwell, Bryan D.

doi:10.7547/14-088.1

Cited by 10 publications

(16 citation statements)

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“…47 Using data from the duplicate Phase III trials, a post hoc analysis was performed to analyze the efficacy of efinaconazole 10% topical solution in onychomycosis patients who also had coexisting tinea pedis. It was found that 21.3% (352/1,655) of onychomycosis study patients reported interdigital tinea pedis at baseline, 48 which is consistent with previous reports. 49 Although the studies were not designed to investigate tinea pedis treatment, investigator-approved topical antifungals were allowed.…”

Section: Studies On Coexisting Tinea Pedis With Onychomycosissupporting

confidence: 90%

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Efinaconazole in the treatment of onychomycosis

Lipner

Scher

2015

IDR

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Efinaconazole 10% topical solution is a new triazole recently approved for the treatment of onychomycosis. It inhibits fungal lanosterol 14α-demethylase in the ergosterol biosynthesis pathway, has potent antifungal activity against dermatophytes, as well as activity against Candida spp. and non-dermatophyte molds, and showed promising results in clinical trials. This review summarizes the mechanism of action, in vitro and in vivo data, clinical trials, safety, and quality-of-life data of efinaconazole as it applies to the treatment of onychomycosis.

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Section: Studies On Coexisting Tinea Pedis With Onychomycosissupporting

confidence: 90%

“…On the other hand, when tinea pedis was not treated, complete cure rates were 16.1% ( P =0.045 vs vehicle), and mycological cure rates were 45.2% ( P =0.007). 48 These data suggest that greater efficacy in onychomycosis treatment may be achieved with concurrent treatment of tinea pedis.…”

Section: Studies On Coexisting Tinea Pedis With Onychomycosismentioning

confidence: 96%

Efinaconazole in the treatment of onychomycosis

Lipner

Scher

2015

IDR

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“…72 There were subgroups of patients who exhibited elevated cure rates after a shorter period of time than that needed for the main cohort; they included female subjects, persons with onychomycosis of the great toenail only, those with a relatively short duration of disease, and those lacking tinea pedis. 72,[128][129][130][131][132] Preliminary data suggest that efinaconazole can be applied safely beyond 1 year and the efficacy rates after 18-24 months of application are higher than those seen after 12 months of usage. 133 The pharmacokinetics, efficacy and safety of efinaconazole 10% were assessed in a phase 4, open-label study for the treatment of paediatric onychomycosis.…”

Section: Topical Treatmentsmentioning

confidence: 99%

“…There were subgroups of patients who exhibited elevated cure rates after a shorter period of time than that needed for the main cohort; they included female subjects, persons with onychomycosis of the great toenail only, those with a relatively short duration of disease, and those lacking tinea pedis 72,128–132 …”

Section: Treatment Optionsmentioning

confidence: 99%

Onychomycosis: a review

Gupta

Stec

Summerbell

et al. 2020

Acad Dermatol Venereol

199

245

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Onychomycosis is a fungal infection of the nail, causing discoloration and thickening of the affected nail plate, and is the most common nail infection worldwide. Onychomycosis was initially thought to be predominantly caused by dermatophytes; however, new research has revealed that mixed infections and those caused by non‐dermatophyte moulds (NDMs) are more prevalent than previously thought, especially in warmer climates. Microscopy and fungal culture are the gold standard techniques for onychomycosis diagnosis, but high false‐negative rates have pushed for more accurate methods, such as histology and PCR. As NDMs are skin and laboratory contaminants, their presence as an infectious agent requires multiple confirmations and repeated sampling. There are several treatment options available, including oral antifungals, topicals and devices. Oral antifungals have higher cure rates and shorter treatment periods than topical treatments, but have adverse side effects such as hepatotoxicity and drug interactions. Terbinafine, itraconazole and fluconazole are most commonly used, with new oral antifungals such as fosravuconazole being evaluated. Topical treatments, such as efinaconazole, tavaborole, ciclopirox and amorolfine have less serious side effects, but also have generally lower cure rates and much longer treatment regimens. New topical formulations are being investigated as faster‐acting alternatives to the currently available topical treatments. Devices such as lasers have shown promise in improving the cosmetic appearance of the nail, but due to a high variation of study methods and definitions of cure, their effectiveness for onychomycosis has yet to be sufficiently proven. Recurrence rates for onychomycosis are high; once infected, patients should seek medical treatment as soon as possible and sanitize their shoes and socks. Prophylactic application of topicals and avoiding walking barefoot in public places may help prevent recurrence.

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“…It is therefore important to treat the tinea pedis with an effective agent when treating the toenails with a topical solution 3,13 . With both ciclopirox 8% nail lacquer topical solution 26 and efinaconazole topical solution 10% 27 it has been observed that the treatment of tinea pedis results in better response to the topical nail solution being used to treat the onychomycosis. Additionally, if the parents or close contacts have onychomycosis or tinea pedis treatment should be considered 3,13,28,29 …”

Section: Discussionmentioning

confidence: 99%

Labeled use of efinaconazole topical solution 10% in treating onychomycosis in children and a review of the management of pediatric onychomycosis

Gupta

Venkataraman

Shear

et al. 2020

Dermatologic Therapy

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Onychomycosis is a difficult to treat condition whose prevalence is increasing. Until recently, there was no FDA approved antifungal agent for the treatment of onychomycosis in children. Although systemic antifungal agents are effective, their use is restricted by the potential adverse events and drug‐drug interactions. There is evidence regarding the safety and efficacy of topical antifungal agents for pediatric onychomycosis. We have summarized the results of a recently published study using efinaconazole topical solution 10% to treat onychomycosis in children and discuss management of pediatric onychomycosis. In a multicenter, open‐label phase 4 study, efinaconazole 10% solution was applied topically once daily in children aged 6 to 16 years with mild to severe, culture positive, distal and lateral subungual onychomycosis. Treatment was for 48 weeks with a follow‐up at week 52. Pharmacokinetics was performed in a subset of patients. There were 62 patients enrolled in the study. At week 52, the efficacy was mycological cure rate 65% and complete cure rate 40%. All treatment‐emergent adverse events (TEAE) were mild to moderate in severity with none resulting in study discontinuation. The only treatment‐related TEAE was ingrown toenail. Efinaconazole was detected at low levels in plasma. Efinaconazole topical solution 10% is effective and safe in treating onychomycosis in children age 6 to 16 years and was recently FDA‐approved for this indication. The on‐label use of other topical agents, tavaborole solution 5% and ciclopirox nail lacquer solution 8% is reviewed. We also briefly discuss the use of oral agents, terbinafine, itraconazole, and fluconazole in pediatric onychomycosis.

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Efinaconazole Topical Solution, 10%: Efficacy in Patients with Onychomycosis and Coexisting Tinea Pedis

Abstract: Treatment of coexisting tinea pedis in patients with onychomycosis enhances the efficacy of once-daily topical treatment with efinaconazole topical solution, 10%.

Cited by 10 publications

References 0 publications

Efinaconazole in the treatment of onychomycosis

Efinaconazole in the treatment of onychomycosis

Onychomycosis: a review

Labeled use of efinaconazole topical solution 10% in treating onychomycosis in children and a review of the management of pediatric onychomycosis

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