Pulse versus continuous terbinafine for onychomycosis: A randomized, double-blind, controlled trial

Update on terbinafine with a focus on dermatophytoses

“…Mycological cure of the target toenail (71% vs 59%); clinical cure of the target toenail (45% vs 29%); complete cure of the target toenail (40% vs 28%); and complete cure of all 10 toenails (25% vs 15%) were all statistically greater with standard dosing. 125 No signifi cant differences in complete cure have been observed based on the number of pulses administered; however, a clear trend is noted with response rates increasing steadily from one to four pulses. 126 As noted with traditional dosing, higher cure rates were observed for fi ngernails treated with pulsedosing as compared with toe nails.…”

Commentary: The illusory tinea unguium cure

“…New and variable pulsed dosing regimens are being tested for oral agents. [6][7][8] The ultimate goal is finding a drug with good long-term cure rates; that concentrates in the nail bed and nail plate at levels toxic to the fungus but not the patient; with limited drug-drug interactions; with few if any side effects; and that does not bankrupt the patients or health care system. So far, that goal has been elusive at its most basic premise, with long-term complete cure rates that are disappointing.…”

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

“…The newer topical products efinaconazole 10% and tavabarole 5%, were approved for the treatment of onychomycosis of toenails due to Trichophyton rubrum or Trichophton mentagrophytes. 7,8 The efficacy in the phase III trials was better than previously available topical antifungals, but remains below that of oral agents such as terbinafine and itraconazole, [9][10][11][12][13][14][15][16][17][18] Even with oral therapy in onychomycosis, recurrence rates…”