Shemer Avner, Gupta Aditya K, Babaev Meir, Barzilai Aviv, Farhi Renata, Daniel Iii C Ralph
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Department of Medicine, University of Toronto, Toronto, ON, Canada.
Skin Appendage Disord. 2018 Aug;4(3):166-170. doi: 10.1159/000484211. Epub 2017 Nov 16.
Onychomycosis is a difficult-to-treat fungal infection of the nails. The efficacy of monotherapy is not ideal, and combination therapies provide an alternative that may increase treatment efficacy.
A retrospective analysis of data from 91 patients was undertaken. Treatment for toenail onychomycosis occurred between 2014 and 2016 and consisted of combination therapy with oral terbinafine (250 mg/day for 12 weeks) or itraconazole (3 pulses, 400 mg/day for 7 days) + K101 nail solution daily, or K101 nail solution monotherapy. Efficacy outcomes at 12 and 15 months were analyzed.
At 12 months, the clinical cure rate for combination of terbinafine + K101 solution was significantly higher than that for K101 monotherapy ( = 0.008). Patients receiving this combination also showed significant improvement in percent of affected nail at 3 months ( = 0.029), while patients receiving itraconazole + K101 solution demonstrated improvement in percent of affected nail at 6 months ( = 0.037). At 15 months, there was no significant difference between treatments for complete, clinical, and mycological cure.
Combination therapy with oral terbinafine or itraconazole and K101 nail solution results in clearance of infected nail earlier than that with topical K101 alone. These combinations may encourage compliance and be effective for patients with moderate onychomycosis.
甲癣是一种难以治疗的指甲真菌感染。单一疗法的疗效不理想,联合疗法提供了一种可能提高治疗效果的替代方案。
对91例患者的数据进行回顾性分析。2014年至2016年期间对趾甲甲癣进行治疗,治疗方法包括口服特比萘芬(250毫克/天,共12周)或伊曲康唑(3个疗程,400毫克/天,共7天)联合K101甲液每日使用,或K101甲液单一疗法。分析了12个月和15个月时的疗效结果。
在12个月时,特比萘芬联合K101甲液的临床治愈率显著高于K101单一疗法(P = 0.008)。接受该联合治疗的患者在3个月时患甲百分比也有显著改善(P = 0.029),而接受伊曲康唑联合K101甲液治疗的患者在6个月时患甲百分比有所改善(P = 0.037)。在15个月时,各治疗组在完全治愈、临床治愈和真菌学治愈方面无显著差异。
口服特比萘芬或伊曲康唑与K101甲液联合治疗比单独使用外用K101能更早清除感染的指甲。这些联合治疗可能会提高患者的依从性,对中度甲癣患者有效。