Sprenger Anarosa B, Purim Katia Sheylla Malta, Sprenger Flávia, Queiroz-Telles Flávio
Santa Casa de Curitiba Hospital, Clinic of Diseases and Surgery of the Nail Apparatus, Department of Dermatology, Praça Rui Barbosa, 694, 80.010-030 Curitiba, Brazil.
Hospital de Clínicas de Curitiba-Universidade Federal do Paraná (UFPR), Clinic of Dermatology, Rua General Carneiro, 181, 80.060-900 Curitiba, Brazil.
J Fungi (Basel). 2019 Sep 4;5(3):82. doi: 10.3390/jof5030082.
Terbinafine has proved to treat numerous fungal infections, including onychomycosis, successfully. Due to its liver metabolization and dependency on the cytochrome P450 enzyme complex, undesirable drug interaction are highly probable. Additionally to drug interactions, the treatment is long, rising the chances of the appearance of side effects and abandonment. Pharmacokinetic data suggest that terbinafine maintains a fungicidal effect within the nail up to 30 weeks after its last administration, which has aroused the possibility of a pulse therapy to reduce the side effects while treating onychomycosis. This study's goal was to evaluate the effectiveness of three different oral terbinafine regimens in treating onychomycosis due to dermatophytes. Sixty-three patients with onychomycosis were sorted by convenience in three different groups. Patients from group 1 received the conventional terbinafine dose (250 mg per day for 3 months). Group 2 received a monthly week-long pulse-therapy dose (500 mg per day for 7 days a month, for 4 months) and group 3 received a 500 mg/day dose for 7 days every 3 months, totaling four treatments. There were no statistical differences regarding the effectiveness or side effects between the groups. Conclusion: A quarterly terbinafine pulse regimen can be a possible alternative for treating onychomycosis caused by dermatophytes.
特比萘芬已被证明能成功治疗多种真菌感染，包括甲癣。由于其在肝脏代谢且依赖细胞色素P450酶复合物，很可能会出现不良药物相互作用。除了药物相互作用外，治疗时间长，增加了出现副作用和停药的几率。药代动力学数据表明，特比萘芬在最后一次给药后长达30周内在指甲内维持杀菌作用，这引发了采用脉冲疗法在治疗甲癣时减少副作用的可能性。本研究的目的是评估三种不同口服特比萘芬方案治疗皮肤癣菌引起的甲癣的有效性。63例甲癣患者按便利原则分为三组。第1组患者接受常规特比萘芬剂量（每天250mg，共3个月）。第2组接受每月为期一周的脉冲治疗剂量（每月每天500mg，共7天，共4个月），第3组每3个月接受500mg/天剂量，共7天，共进行四次治疗。各组之间在有效性或副作用方面无统计学差异。结论：每季度一次的特比萘芬脉冲方案可能是治疗皮肤癣菌引起的甲癣的一种替代方法。
