Journal Article10.1159/000353667
A multicenter, randomized, open-label, controlled study comparing the efficacy, safety and cost-effectiveness of a sequential therapy with RV4104A ointment, ciclopiroxolamine cream and ciclopirox film-forming solution with amorolfine nail lacquer alone in dermatophytic onychomycosis.
Carle Paul,D. Coustou,M. Lahfa,C. Bulai-Livideanu,N. Doss,I. Mokthar,Hamida Turki,Rafiaa Nouira,Bécima Fazaa,A Ben Osman,O. Zourabichvili,C. Cazeau,H. Coubetergues,S. Picot,A.L. Bienvenu,J.-J. Voisard +15 more
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TL;DR: A treatment of onychomycosis comprising chemical avulsion of the pathological nail, ciclopirox cream and nail Lacquer is significantly more effective than amorolfine nail lacquer.
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Abstract: Background: The efficacy of topical antifungals is controversial. Objective: To compare the efficacy and safety of a sequential (SEQ) treatment with chemical nail avulsion and topical antifungals to amorolfine nail lacquer in dermatophytic onychomycosis. Methods: This was a randomized, parallel-group, controlled study comparing a 36-week SEQ treatment with chemical nail avulsion with RV4104A ointment (class I medical device containing 40% urea) followed by ciclopirox cream for 8 weeks and ciclopirox nail lacquer for 25 weeks (SEQ group) to amorolfine nail lacquer for 36 weeks (AMO group). Patients had to have a big toenail onychomycosis, sparing the matrix. The primary efficacy criterion was complete cure at week 48. A cost-effectiveness analysis was performed. Results: A total of 142 patients were randomized. The complete cure rate at week 48 was significantly higher in the SEQ group than in the AMO group (36.6 vs. 12.7%, p = 0.001). Clinical cure at week 48 was observed in 53.5% of patients in the SEQ group versus 17% in the AMO group (p Conclusion: A treatment of onychomycosis comprising chemical avulsion of the pathological nail, ciclopirox cream and nail lacquer is significantly more effective than amorolfine nail lacquer.
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Citations
Topical and device-based treatments for fungal infections of the toenails
Kelly A. Foley,Aditya K. Gupta,Sarah G Versteeg,Rachel R. Mays,Elmer Virgil Villanueva,Denny John +5 more
TL;DR: Assessment of the clinical and mycological effects of topical drugs and device-based therapies for toenail onychomycosis finds that ciclopirox lacquer may lead to increased adverse events, commonly application reactions, rashes, and nail alteration, and that tavaborole 5% solution is probably more effective in achievingMycological cure.
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Methyl aminolevulinate photodynamic therapy for onychomycosis: a multicentre, randomized, controlled clinical trial
TL;DR: Onychomycosis is a common fungal nail infection that responds poorly to antifungals and needs to be treated with an anti-fungal treatment.
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Fungal nail infection: diagnosis and management.
Samantha Eisman,Rodney Sinclair +1 more
TL;DR: This review provides an evidence based overview of the diagnosis and management of onychomycosis and consulted recent guidelines submitted for publication by the British Association of Dermatologists.
Antifungal therapy for onychomycosis in children.
TL;DR: Due to their thinner, faster-growing nails, children are more likely to respond to topical monotherapy than adults and there is currently insufficient data comparing emerging medical devices with standard therapeutic options to recommend their use in children.
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Combination therapy for onychomycosis using a fractional 2940-nm Er:YAG laser and 5 % amorolfine lacquer
TL;DR: This clinical study suggests that combination therapy of a fractional 2940-nm Er:YAG laser and 5 % amorolfine lacquer is an effective, safe, and convenient treatment method for onychomycosis.
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