Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, P.R.China.
Dermatology, Zhangjiagang second people's hospital, Suzhou, China.
Mycoses. 2018 Oct;61(10):736-742. doi: 10.1111/myc.12799. Epub 2018 Jul 5.
Although standard itraconazole pulse therapy is a well-established regimen for toenail onychomycosis, the cure rate for onychomycosis remains low. To evaluate the efficacy and safety of different cycles of itraconazole pulse therapy, determine the optimal dosage and number of cycles for onychomycosis. A total of 90 outpatients of our hospital with onychomycosis were randomised into three treatment groups: (1) standard itraconazole pulse therapy (200 mg twice per day, 1 week each month for three pulses); (2) long-term pulse therapy (200 mg twice per day, 1 week each month for six pulses); (3) low-dose and long-term pulse therapy (200 mg/d, 1 week per month for six pulses) and were followed up for 15 months. Of the initial patients, the trial was completed by 81 patients. The complete cure rates were 32.43% for three cycles and 75% for six cycles (P < .001). For six cycles, despite the administration of half-dose for patients weighing no more than 55 kg, there was no statistical difference in the complete cure rate (P = .862). Long-term therapy is effective and safe for the treatment of toenail onychomycosis. For patients weighing no more than 55 kg, long-term half-dose itraconazole pulse therapy is recommended .
虽然标准的伊曲康唑冲击疗法是治疗趾甲甲真菌病的成熟方案，但甲真菌病的治愈率仍然较低。为了评估不同周期伊曲康唑冲击疗法的疗效和安全性，确定甲真菌病的最佳剂量和周期数。将我院 90 例趾甲真菌病患者随机分为三组：（1）标准伊曲康唑冲击疗法（200mg，每日两次，每月 1 次，共 3 个脉冲）；（2）长期脉冲疗法（200mg，每日两次，每月 1 次，共 6 个脉冲）；（3）低剂量和长期脉冲疗法（200mg/d，每月 1 周，共 6 个脉冲），随访 15 个月。最初的患者中，有 81 例完成了试验。三个周期的完全治愈率为 32.43%，六个周期的完全治愈率为 75%（P<0.001）。对于六个周期，尽管体重不超过 55kg 的患者给予半剂量，但完全治愈率无统计学差异（P=0.862）。长期治疗对治疗趾甲甲真菌病有效且安全。对于体重不超过 55kg 的患者，建议长期使用半剂量伊曲康唑冲击疗法。
