Onychomycosis in Special Populations

Chiacchio, Nilton Di; Chiacchio, Nilton Gioia Di

doi:10.1002/9781119226512.ch21

Cited by 1 publication

(1 citation statement)

References 53 publications

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“…Onychomycosis (ONC), the most common worldwide nail infection, is a fungal infection caused by both dermatophytes and non-dermatophytes [ 1 , 2 ]. Its incidence is rising due to the ageing population (ONC prevalence increases with age, affecting 20% to 50% of individuals over 60 years of age) [ 1 , 2 , 3 , 4 , 5 ] and increasing numbers of diabetic patients, who are 2.5 times more likely to develop ONC [ 2 , 5 , 6 , 7 ]. The challenges found in the development of efficacious topical treatments for onychomycosis have stimulated research on new formulations and enhancement approaches that may lead to more efficient topical medicines [ 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

New Formulation–Microporation Combination Approaches to Delivering Ciclopirox across Human Nails

Kishishita,

de Almeida Perez Pimenta,

Cerqueira Macedo

et al. 2024

Pharmaceutics

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Topical treatments for onychomycosis are of interest to those seeking to avoid systemic drug interactions and to improve systemic safety. This work aimed to develop aqueous-based, simple, and cost-effective vehicles that provide high solubility for ciclopirox and enable the delivery of an active through channels created by nail microporation. Following solubility tests, aqueous gels and thermogels based on hydroxypropylmethylcellulose and poloxamer 407, respectively, were loaded with 8% and 16% ciclopirox. Their performance was then compared to the marketed lacquer Micolamina® in in vitro release tests with artificial membranes and in in vitro permeation tests with human nail clippings with and without poration. Finally, a microbiological assay compared the best gel formulations and the reference product. Little correlation was observed between the in vitro release and the permeation data, and the drug release was highly membrane-dependent. Ciclopirox nail retention in single-dose, porated nails tests was larger than in daily-dosing, non-porated nail conditions. The series of new gel and thermogel vehicles delivered ciclopirox more effectively than Micolamina® in single-dose, porated nail experiments. The inhibition of Trichophyton rubrum activity was significantly increased with microporated nails when the gel formulations were applied but not with Micolamina®. Overall, the results suggest that the new vehicles could be successfully combined with nail microporation to improve the drug delivery and efficacy of topical antifungal medication while reducing the dosing frequency, facilitating patients’ adherence.

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