Source: DGNews  |  Posted 8 years ago

By Alison Palkhivala

SAN FRANCISCO, CA -- March 26, 2003 -- Treating severe toenail onychomycosis with a combination of oral terbinafine therapy and ciclopirox lacquer may offer a quicker response rate than treatment with terbinafine alone, according to preliminary results of an ongoing study.

In a multicentre trial led by Aditya K. Gupta, MD, PhD, from University of Toronto, Ontario, Canada, 121 patients with severe toenail onychomycosis were randomised to one of three treatment arms: 1) terbinafine 250 mg/day for 4 weeks, with 4 weeks off, followed by another 4 weeks of the drug in addition to 48 weeks of daily application of ciclopirox nail lacquer; 2) terbinafine 250 mg/day for 12 weeks in addition to 48 weeks of daily application of ciclopirox nail lacquer; 3) terbinafine 250 mg/day for 12 weeks as monotherapy.

Dr. Gupta presented the results of the interim analysis in a poster on March 22nd here at the 61st Annual Meeting of the American Academy of Dermatology.

Among the patients who had positive mycological cultures at baseline, nearly 90% of those using combination therapy with oral terbinafine and ciclopirox lacquer converted to negative cultures by Week 4, compared with only 27% of those using terbinafine alone. This proportion of negative cultures was maintained at 12 weeks in the combination group and increased to 46% in the monotherapy group.

Based on these findings, the authors concluded that combination therapy with oral terbinafine and topical ciclopirox lacquer may provide patients with culture-negative results sooner than treatment with terbinafine alone.

[Study title: Mycologic Response to Terbinafine Treatment of Severe Onychomycosis with or without Ciclopirox Nail Lacquer Interim Results. Abstract p438]