Long-term Effectiveness of Treatment With Terbinafine vs Itraconazole in Onychomycosis

Sigurgeirsson, Bárður; Ólafsson, Jón; Steinsson, Jón þ; Paul, Carle; Billstein, Stephan; Evans, E. G. V.

doi:10.1001/archderm.138.3.353

Cited by 189 publications

(150 citation statements)

References 25 publications

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“…Nevertheless, a long-period treatment over 3 months does not lead to cure rates above 80% for toenails (31), and relapse often occurs after treatment (4,21,30). Presumably because oral antifungal drugs cannot remove fungi from nails before nails are turned over, the pace of response of tinea unguium seems to be a function of the nail growth rate.…”

mentioning

confidence: 99%

Therapeutic Efficacy of Topically Applied KP-103 against Experimental Tinea Unguium in Guinea Pigs in Comparison with Amorolfine and Terbinafine

Tatsumi

Yokoo

Senda

et al. 2002

Antimicrob Agents Chemother

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The therapeutic efficacy of KP-103, a novel topical triazole, in a guinea pig tinea unguium model was investigated. Experimental tinea unguium and tinea pedis were produced by inoculation of Trichophyton mentagrophytes SM-110 between the toes of the hind paw of guinea pigs. One percent solution (0.1 ml) of KP-103, amorolfine, or terbinafine was topically applied to the nails and whole sole of an infected foot once daily for 30 consecutive days, and terbinafine was also orally administered at a daily dose of 40 mg/kg of body weight for 30 consecutive days, starting on day 60 postinfection. The fungal burdens of nails and plantar skin were assessed using a new method, which makes it possible to recover infecting fungi by removing a carryover of the drug remaining in the treated tissues into the culture medium. Topically applied KP-103 inhibited the development of nail collapse, significantly reduced the fungal burden of the nails, and sterilized the infected plantar skin. On the other hand, topical amorolfine and topical or oral terbinafine were ineffective for tinea unguium, although these drugs eradicated or reduced the fungal burden of plantar skin. The in vitro activities of amorolfine and terbinafine against T. mentagrophytes SM-110 were 8-and 32-fold, respectively, decreased by the addition of 5% keratin to Sabouraud dextrose broth medium. In contrast, the activity of KP-103 was not affected by keratin because its keratin affinity is lower than those of the reference drugs, suggesting that KP-103 largely exists in the nails as an active form that was not bound to keratin and diffuses in the nail without being trapped by keratin. The effectiveness of KP-103 against tinea unguium is probably due to its favorable pharmacokinetic properties in the nails together with its potent antifungal activity.

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confidence: 99%

Therapeutic Efficacy of Topically Applied KP-103 against Experimental Tinea Unguium in Guinea Pigs in Comparison with Amorolfine and Terbinafine

Tatsumi

Yokoo

Senda

et al. 2002

Antimicrob Agents Chemother

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“…The cure of onychomycosis is known to be strenuous since it is chronic, difficult to obliterate and tends to relapse [36][37][38][39]. The pharmacotherapy for onychomycosis widely involves the oral antifungals because their systemic or circulatory distribution allows them to penetrate the nail apparatus and the nail plate.…”

Section: Topical Therapymentioning

confidence: 99%

Is This the Right Drug or the Dose for the Management of Onychomycosis?

Thatai¹,

Sapra²

2017

J Cosmo Trichol

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“…have been reported to be as high as 57%, [19][20][21][22][23][24] and with antifungal therapy alone (whether oral or topical), the underlying onychodystrophy that preceded or followed as a result of the fungal disease is not primarily addressed. In reality, onychomycosis is most often an end result of environmental conditions affecting the nails involving microtrauma, nail dystrophy (any alteration of nail morphology 25 ), and a "pedal fungus reservoir" in a susceptible host.…”

Section: Fpomentioning

confidence: 99%

Efinaconazole 10% and Tavaborole 5% Penetrate Across Poly-ureaurethane 16%: Results of In Vitro Release Testing and Clinical Implications of Onychodystrophy in Onychomycosis

Adigun¹,

Vlahovic²,

McClellan³

et al. 2017

J of Skin

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Long-term Effectiveness of Treatment With Terbinafine vs Itraconazole in Onychomycosis

Cited by 189 publications

References 25 publications

Therapeutic Efficacy of Topically Applied KP-103 against Experimental Tinea Unguium in Guinea Pigs in Comparison with Amorolfine and Terbinafine

Therapeutic Efficacy of Topically Applied KP-103 against Experimental Tinea Unguium in Guinea Pigs in Comparison with Amorolfine and Terbinafine

Is This the Right Drug or the Dose for the Management of Onychomycosis?

Efinaconazole 10% and Tavaborole 5% Penetrate Across Poly-ureaurethane 16%: Results of In Vitro Release Testing and Clinical Implications of Onychodystrophy in Onychomycosis

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