Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field OBJECTIVE: To examine long-term cure and relapse rates after treatment with continuous terbinafine and intermittent itraconazole in onychomycosis. DESIGN: Long-term prospective follow-up st...
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Online Access: | http://hdl.handle.net/2336/31871 https://doi.org/10.1001/archderm.138.3.353 |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/31871 2023-05-15T16:52:20+02:00 Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study Sigurgeirsson, B Olafsson, JH Steinsson, JB Paul, C Billstein, S Evans, EV Department of Dermatology, University of Iceland, Reykjavik. bsig@isholf.is 2008-07-14 http://hdl.handle.net/2336/31871 https://doi.org/10.1001/archderm.138.3.353 en eng American Medical Assn. http://archderm.ama-assn.org/cgi/content/abstract/138/3/353 Arch Dermatol. 2002, 138(3):353-7 0003-987X 11902986 doi:10.1001/archderm.138.3.353 http://hdl.handle.net/2336/31871 Archives of dermatology Adult Aged Antifungal Agents Double-Blind Method Follow-Up Studies Foot Dermatoses Humans Itraconazole Longitudinal Studies Middle Aged Naphthalenes Onychomycosis Prospective Studies Recurrence Retreatment Tinea Treatment Outcome Trichophyton Article 2008 ftlandspitaliuni https://doi.org/10.1001/archderm.138.3.353 2022-05-29T08:21:10Z To access publisher full text version of this article. Please click on the hyperlink in Additional Links field OBJECTIVE: To examine long-term cure and relapse rates after treatment with continuous terbinafine and intermittent itraconazole in onychomycosis. DESIGN: Long-term prospective follow-up study. SETTING: Three centers in Iceland. SUBJECTS: The study population comprised 151 patients aged 18 to 75 years with a clinical and mycological diagnosis of dermatophyte toenail onychomycosis. INTERVENTIONS: In a double-blind, double-dummy study, patients were randomized to receive either terbinafine (250 mg/d) for 12 or 16 weeks or itraconazole (400 mg/d) for 1 week in every 4 for 12 or 16 weeks (first intervention). Patients who did not achieve clinical cure at month 18 or experienced relapse or reinfection were offered an additional course of terbinafine (second intervention). MAIN OUTCOME MEASURES: The primary efficacy criterion was mycological cure, defined as negative results on microscopy and culture at the end of follow-up and no requirement of second intervention treatment. Secondary efficacy criteria included clinical cure without second intervention treatment and mycological and clinical relapse rates. RESULTS: Median duration of follow-up was 54 months. At the end of the study, mycological cure without second intervention treatment was found in 34 (46%) of the 74 terbinafine-treated subjects and 10 (13%) of the 77 itraconazole-treated subjects (P<.001). Mycological and clinical relapse rates were significantly higher in itraconazole vs terbinafine-treated patients (53% vs 23% and 48% vs 21%, respectively). Of the 72 patients who received subsequent terbinafine treatment, 63 (88%) achieved mycological cure and 55 (76%) achieved clinical cure. CONCLUSION: In the treatment of onychomycosis, continuous terbinafine provided superior long-term mycological and clinical efficacy and lower rates of mycological and clinical relapse compared with intermittent itraconazole. Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Archives of Dermatology 138 3 |
institution |
Open Polar |
collection |
Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
English |
topic |
Adult Aged Antifungal Agents Double-Blind Method Follow-Up Studies Foot Dermatoses Humans Itraconazole Longitudinal Studies Middle Aged Naphthalenes Onychomycosis Prospective Studies Recurrence Retreatment Tinea Treatment Outcome Trichophyton |
spellingShingle |
Adult Aged Antifungal Agents Double-Blind Method Follow-Up Studies Foot Dermatoses Humans Itraconazole Longitudinal Studies Middle Aged Naphthalenes Onychomycosis Prospective Studies Recurrence Retreatment Tinea Treatment Outcome Trichophyton Sigurgeirsson, B Olafsson, JH Steinsson, JB Paul, C Billstein, S Evans, EV Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study |
topic_facet |
Adult Aged Antifungal Agents Double-Blind Method Follow-Up Studies Foot Dermatoses Humans Itraconazole Longitudinal Studies Middle Aged Naphthalenes Onychomycosis Prospective Studies Recurrence Retreatment Tinea Treatment Outcome Trichophyton |
description |
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field OBJECTIVE: To examine long-term cure and relapse rates after treatment with continuous terbinafine and intermittent itraconazole in onychomycosis. DESIGN: Long-term prospective follow-up study. SETTING: Three centers in Iceland. SUBJECTS: The study population comprised 151 patients aged 18 to 75 years with a clinical and mycological diagnosis of dermatophyte toenail onychomycosis. INTERVENTIONS: In a double-blind, double-dummy study, patients were randomized to receive either terbinafine (250 mg/d) for 12 or 16 weeks or itraconazole (400 mg/d) for 1 week in every 4 for 12 or 16 weeks (first intervention). Patients who did not achieve clinical cure at month 18 or experienced relapse or reinfection were offered an additional course of terbinafine (second intervention). MAIN OUTCOME MEASURES: The primary efficacy criterion was mycological cure, defined as negative results on microscopy and culture at the end of follow-up and no requirement of second intervention treatment. Secondary efficacy criteria included clinical cure without second intervention treatment and mycological and clinical relapse rates. RESULTS: Median duration of follow-up was 54 months. At the end of the study, mycological cure without second intervention treatment was found in 34 (46%) of the 74 terbinafine-treated subjects and 10 (13%) of the 77 itraconazole-treated subjects (P<.001). Mycological and clinical relapse rates were significantly higher in itraconazole vs terbinafine-treated patients (53% vs 23% and 48% vs 21%, respectively). Of the 72 patients who received subsequent terbinafine treatment, 63 (88%) achieved mycological cure and 55 (76%) achieved clinical cure. CONCLUSION: In the treatment of onychomycosis, continuous terbinafine provided superior long-term mycological and clinical efficacy and lower rates of mycological and clinical relapse compared with intermittent itraconazole. |
author2 |
Department of Dermatology, University of Iceland, Reykjavik. bsig@isholf.is |
format |
Article in Journal/Newspaper |
author |
Sigurgeirsson, B Olafsson, JH Steinsson, JB Paul, C Billstein, S Evans, EV |
author_facet |
Sigurgeirsson, B Olafsson, JH Steinsson, JB Paul, C Billstein, S Evans, EV |
author_sort |
Sigurgeirsson, B |
title |
Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study |
title_short |
Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study |
title_full |
Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study |
title_fullStr |
Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study |
title_full_unstemmed |
Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study |
title_sort |
long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study |
publisher |
American Medical Assn. |
publishDate |
2008 |
url |
http://hdl.handle.net/2336/31871 https://doi.org/10.1001/archderm.138.3.353 |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://archderm.ama-assn.org/cgi/content/abstract/138/3/353 Arch Dermatol. 2002, 138(3):353-7 0003-987X 11902986 doi:10.1001/archderm.138.3.353 http://hdl.handle.net/2336/31871 Archives of dermatology |
op_doi |
https://doi.org/10.1001/archderm.138.3.353 |
container_title |
Archives of Dermatology |
container_volume |
138 |
container_issue |
3 |
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1766042475824152576 |