Treatment of dermatophyte nail infections: An open randomized study comparing intermittent terbinafine therapy with continuous terbinafine treatment and intermittent itraconazole therapy

Relapses of Onychomycosis after Successful Treatment with Systemic Antifungals: A Three-Year Follow-Up

“…Data about relapses of onychomycosis after treatment with the new systemic antifungals vary in the different studies, with figures ranging from 3 to 20% [4, 5, 6, 7, 8]for terbinafine and from 21 to 27% for itraconazole [9, 10, 11], depending on the follow-up duration. Studies that have followed patients for more than 1 year after the end of therapy usually report a significantly higher relapse rate than short-term studies.…”

“…These patients include all the patients with toenail onychomycosis mycologically cured from a group of 63 patients who entered an open randomized study comparing intermittent itraconazole treatment with continuous terbinafine treatment and intermittent terbinafine therapy [10]. …”

Oral Treatments for Toenail Onychomycosis

“…* Some authors simply failed to present data for all intended outcomes. 15,36,38 The use of line graphs, means without measures of variance, and P values to present clinical cure data hampered the production of a coherent data summary of clinical cure rates. 13 Only Ling et al, 24 Evans and Sigurgeirsson, 17 and Gupta et al 11 presented data in absolute numbers for clinical cures they defined a priori.…”

“…The cure rates achieved in the terbinafine arms of the trial, relative to the itraconazole arms, are consistent with the meta-analysis in the Figure and provide evidence that continuous treatment with terbinafine (250 mg/d) is significantly more effective than an intermittent regimen of itraconazole (400 mg/d). The small trial by Alpsoy et al 18 and data from the arm of the trial evaluating intermittent and continuous dosages of terbinafine in the study by Tosti et al 38 both suggest that high levels of effectiveness can be achieved using a intermittent regimen of terbinafine, but this needs to be evaluated in a large randomized controlled trial.…”

Onychomycosis: Improved Cure Rates with Itraconazole and Terbinafine

“…Tosti et al 9 reported the results of an open, randomized trial comparing intermittent terbinafine therapy with continuous terbinafine therapy and intermittent itraconazole therapy. This small trial consisted of 63 patients who were randomized to receive terbinafine 250 mg daily for 12 weeks, terbinafine 500 mg daily for 1 week every month for 4 months, or itraconazole 400 mg daily for 1 week every month for 4 months.…”