Clinical trial designs for topical antifungal treatments of onychomycosis and implications on clinical practice.

Abstract:

:There currently are 3 topical agents approved by the US Food and Drug Administration (FDA) to treat onychomycosis: tavaborole, efinaconazole, and ciclopirox. The phase 3 clinical trial designs for these treatments and their notable differences make it difficult for clinicians to interpret the data into clinical practice. For example, the primary end point predominantly used to assess efficacy in all the trials is complete cure, defined as no involvement of the nail plus mycologic cure; also, a notable number of patients fail to achieve a complete cure despite clear improvement in the nail. Despite close similarities in the end points and overall design of the clinical trials used for these agents, differences in design are notable, including the age range of participants, the range of mycotic nail involvement, the presence/absence of tinea pedis, and the nail trimming/debridement protocols used. The differences in clinical trial designs for the 3 FDA-approved topical agents and the lack of head-to-head studies makes efficacy interpretation and comparison inappropriate. This article reviews the phase 3 clinical trials that led to FDA approval of these agents, focusing on their similarities and differences.

journal_name

Cutis

journal_title

Cutis

authors

Rich P,Vlahovic TC,Joseph WS,Zane LT,Hall SB,Gellings Lowe N,Adigun CG

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

259-264

issue

4

eissn

0011-4162

issn

2326-6929

journal_volume

100

pub_type

杂志文章

相关文献

CUTIS文献大全
  • Genital psoriasis.

    abstract::Psoriasis of the genitalia occurs in all age groups from infancy to the elderly. Approximately one-quarter to one-half of various epidemiologic studies report that genital psoriasis occurs with a higher frequency in males than in females. Therapeutic modalities for management of psoriasis in this site underscore the n...

    journal_title:Cutis

    pub_type: 杂志文章,评审

    doi:

    authors: Farber EM,Nall L

    更新日期:1992-10-01 00:00:00

  • Familial confluent and reticulate papillomatosis successfully treated with minocycline.

    abstract::Confluent and reticulate papillomatosis (CRP) is an idiopathic disorder characterized by persistent patches and plaques that are centrally confluent and peripherally reticulate. Although CRP primarily occurs sporadically, there may be a familial predisposition to the development of CRP. Minocycline has been reported a...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Kim JS,Paek JO,Kang HS,Yu HJ

    更新日期:2014-04-01 00:00:00

  • Aquatic antagonists: stingray injury update.

    abstract::Stingrays cause more sting-related injuries than any other fish. Their venom and mechanism of injury lead to painful, poor-healing wounds that often become infected. Stingray injuries are further complicated by retained barbs and foreign bodies, which also may lead to considerable morbidity. Most stingray injuries can...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Rensch GP,Elston DM

    更新日期:2019-03-01 00:00:00

  • Photo recall-like phenomenon following the use of cefazolin and gentamicin sulfate.

    abstract::A twenty-one-year-old woman being treated as an inpatient for a urinary tract infection with cefazolin and gentamicin showed a photodistributed eruption five days into her hospitalization. Photo recall phenomena are well known to occur in patients receiving chemotherapeutic agents after sustaining prior skin damage fr...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Flax SH,Uhle P

    更新日期:1990-07-01 00:00:00

  • Lichen sclerosus et atrophicus affecting the wrists and left ankle and clinically simulating lichen planus.

    abstract::Lichen sclerosus et atrophicus (LSA) is a disease of unknown etiology, although hereditary, endocrine, and autoimmune factors are known to be involved. Although the anal and genital regions are predominantly affected, 2.5% of patients only present with extragenital lesions--particularly of the trunk, neck, and upper l...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Corbalán-Vélez R,Pérez-Ferriols A

    更新日期:2001-05-01 00:00:00

  • The comparative efficacy of minocycline and penicillin-V in Staphylococcus aureus skin and soft tissue infections.

    abstract::The antistaphylococcal properties of orally administered minocycline and penicillin-V were compared for one hundred and fifteen patients receiving minocycline and one hundred and twenty-eight receiving penicillin-V for various types of cutaneous infections. The majority of bacterial isolates were staphylococcal organi...

    journal_title:Cutis

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Keeney RE,Seamans ML,Russo RM,Gururaj VJ,Allen JE

    更新日期:1979-05-01 00:00:00

  • Adverse effects from topical steroids.

    abstract::The introduction of topical corticosteroids greatly expanded the practitioner's dermatologic armamentarium and at the same time augmented the list of local and systemic iatrogenic diseases with which he must deal. A recent review of the literature was undertaken to determine the adverse effects seen with topically adm...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Hill CJ,Rostenberg A Jr

    更新日期:1978-05-01 00:00:00

  • Dermatologic features of the fat embolism syndrome.

    abstract::Fat embolism syndrome is a life-threatening disease with cutaneous manifestations that occur most commonly after fractures of a long bone. The syndrome consists of a triad of dermatologic, pulmonic, and neurologic involvement. Because no major dermatologic journal has reviewed this syndrome in more than five years, we...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Kaplan RP,Grant JN,Kaufman AJ

    更新日期:1986-07-01 00:00:00

  • Therapeutic studies with a new combination benzoyl peroxide/clindamycin topical gel in acne vulgaris.

    abstract::Three independent clinical studies were conducted in more than 1250 patients with moderate to moderately severe acne vulgaris to evaluate the efficacy and safety of a new combination gel that stably combines 5% benzoyl peroxide and 1% clindamycin. The results indicated that the benzoyl peroxide/clindamycin combination...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Ellis CN,Leyden J,Katz HI,Goldfarb MT,Hickman J,Jones TM,Tschen E

    更新日期:2001-02-01 00:00:00

  • Familial multiple eccrine spiradenomas with cylindromatous features associated with epithelioma adenoides cysticum of Brooke.

    abstract::Four cases of rare familial multiple eccrine spiradenomas showing features of dermal cylindromas and associated with epithelioma adenoides cysticum of Brooke are reported. Skin biopsy specimens were obtained from three generations of this family and routine histochemical and immunoperoxidase stains were used. The elde...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Berberian BJ,Sulica VI,Kao GF

    更新日期:1990-07-01 00:00:00

  • Hypomelanotic canopy of sarcoidosis.

    abstract::A case of cutaneous hypopigmented macules localized above deep dermal and subcutaneous sarcoid granulomas in a patient with systemic sarcoidosis is presented. Melanin was only sparsely distributed in the upper stratum malpighii. Hypopigmentation is an unusual manifestation of sarcoidosis. With an armamentarium of clin...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Hubler WR Jr

    更新日期:1977-01-01 00:00:00

  • Cutaneous larva migrans complicated by erythema multiforme.

    abstract::Cutaneous larva migrans is an intensely pruritic serpiginous eruption caused by the dog or cat hookworm. Often, the disease is self-limiting and no other significant pathology develops; however, a significant localized inflammatory response to the nematode is extremely common. We present a case of cutaneous larva migr...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Vaughan TK,English JC 3rd

    更新日期:1998-07-01 00:00:00

  • Dilantin hypersensitivity reaction.

    abstract::Dilantin hypersensitivity syndrome is characterized by fever, rash, lymphadenopathy, facial edema, and hepatitis. Anemia, pharyngitis, diarrhea, and nephritis may also be present. The eruption may present as the classic erythematous follicular papules and pustules; or it may be pleomorphic, presenting as a morbillifor...

    journal_title:Cutis

    pub_type: 杂志文章,评审

    doi:

    authors: Conger LA Jr,Grabski WJ

    更新日期:1996-04-01 00:00:00

  • Congenital leukonychia striata.

    abstract::Leukonychia striata of a unique appearance and distribution is described in a 51-year-old woman. Histopathologic examination of a specimen from the nail plate revealed a transverse band of parakeratosis on the ventral surface. Disturbance in keratinization on the nail plate is presumed to be secondary to abnormalities...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Mahler RH,Gerstein W,Watters K

    更新日期:1987-05-01 00:00:00

  • Neutrophilic eccrine hidradenitis in a patient with Behçet's disease.

    abstract::Patients with Behçet's disease may develop multiple mucocutaneous manifestations, several of which are mediated by neutrophils. These include aphthous ulcers, pseudofolliculitis, acneform lesions, and pathergy. We report another neutrophil-mediated disorder, neutrophilic eccrine hidradenitis (NEH), in a patient with B...

    journal_title:Cutis

    pub_type: 杂志文章,评审

    doi:

    authors: Bilic M,Mutasim DF

    更新日期:2001-08-01 00:00:00

  • Dermal leishmaniasis after kala-azar infection: successful treatment with rifampin.

    abstract::A patient with dermal leishmaniasis subsequent to kala-azar was treated with sodium stibogluconate, but the condition did not improve. The patient was then treated with rifampin which has not been used to treat this condition in the past. All clinical features cleared spontaneously by six weeks. No overt disease was n...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Saha SK

    更新日期:1985-07-01 00:00:00

  • Systemic antifungals.

    abstract::The administration, effectiveness, action, adverse reactions, and commentary are presented in Table I for a selected number of systemic antifungal agents. ...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Jacobs PH,Nall L

    更新日期:1993-09-01 00:00:00

  • Parenteral short-term corticosteroid therapy in moderate to severe dermatoses. A comparative multiclinic study.

    abstract::Six separate investigators following the methodology stipulated in a common protocol provided a data base of 124 patients with Rhus dermatitis, other contact dermatitis, or atopic dermatitis. In this double-blind study, one or two 1 ml (4.0 mg/ml) intramuscular injections of the new sodium phosphate ester of betametha...

    journal_title:Cutis

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Dickey RF

    更新日期:1976-01-01 00:00:00

  • Lichen planus pemphigoides treated with ustekinumab.

    abstract::A 71-year-old woman presented with pink to violaceous, flat-topped, polygonal papules on the volar wrists, extensor elbows, and bilateral lower legs of 3 years' duration. She also had erythematous, violaceous, infiltrated plaques with microvesiculation on the bilateral thighs of several months' duration. She reported ...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Knisley RR,Petropolis AA,Mackey VT

    更新日期:2017-12-01 00:00:00

  • The diagnosis and treatment of human papillomavirus-mediated genital lesions.

    abstract::Genital warts (condyloma acuminatum, venereal warts) are common highly contagious benign epithelial lesions occurring on the genitals, perianal area, and inguinal folds, and are caused by human papillomavirus (HPV). Diagnosis is based largely on the clinical appearance of lesions. New home-based treatments, including ...

    journal_title:Cutis

    pub_type: 杂志文章,评审

    doi:

    authors: Brodell LA,Mercurio MG,Brodell RT

    更新日期:2007-04-01 00:00:00

  • Erythrodermic mastocytosis.

    abstract::Erythrodermic mastocytosis is a rare variant of diffuse cutaneous mastocytosis in which the skin becomes red, thickened, and lichenified and has a doughy consistency with multiple small papules on its surface, giving a leathery appearance to the skin. In this report, I describe a curious case of erythrodermic mastocyt...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Requena L

    更新日期:1992-03-01 00:00:00

  • Trichophyton tonsurans granuloma in the scalp of an adult.

    abstract::Tinea capitis with granuloma formation in the scalp of an adult that was caused by Tr. tonsurans infection is presented. The lack of symptomatic findings emphasizes the occasional difficulty in making a clinical diagnosis of this condition. Moreover, the possibility of beauty parlors being the source of scalp infectio...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: McNamara RJ

    更新日期:1977-07-01 00:00:00

  • Pyoderma gangrenosum associated with cystic acne and hidradenitis suppurativa controlled by adding minocycline and sulfasalazine to the treatment regimen.

    abstract::Pyoderma gangrenosum often presents a difficult therapeutic challenge. The case is described of a 42-year-old black man with the association of cystic acne, hidradenitis suppurativa, and seronegative arthritis with pyoderma gangrenosum. The pyoderma gangrenosum ulcers remained refractory to treatment until therapies a...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Shenefelt PD

    更新日期:1996-05-01 00:00:00

  • Leukocytoclastic vasculitis following staphylococcal protein A column immunoadsorption therapy for idiopathic thrombocytopenic purpura.

    abstract::A patient with refractory idiopathic thrombocytopenic purpura developed widespread palpable purpura, fever, diarrhea, and arthralgias forty-eight hours following a third protein A immunoadsorption treatment. A skin biopsy revealed leukocytoclastic vasculitis. His skin lesions and constitutional symptoms resolved with ...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Bourelly PE,Grossman ME

    更新日期:1999-10-01 00:00:00

  • Primary apocrine adenocarcinoma of the axilla.

    abstract::Primary apocrine adenocarcinoma (AA) is a rare malignant cutaneous neoplasm that typically arises in areas of high apocrine gland density such as the axillae and the anogenital region. Due to the nonspecific clinical manifestation of AA, the differential diagnosis may be broad. The rarity of this neoplasm has led to a...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Kathrotiya PR,Bridge AT,Warren SJ,Do H,Klenk AS,Xu LY,Mathur AN

    更新日期:2015-05-01 00:00:00

  • Exercise-associated solar purpura in an atypical location.

    abstract::Solar purpura localized to the malar region occurred in a 41-year-old jogger after a six mile run. This eruption is another example of the dermatoses experienced by athletes. ...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Latenser BA,Hempstead RW

    更新日期:1985-04-01 00:00:00

  • Cryptogenic drug eruption resulting from cephalosporin lavage.

    abstract::The actual cause of a drug eruption may not be obvious at times. In such cases, careful review of medication logs, order sheets, and progress notes should be supplemented by nursing notes and verification of treatment given by those responsible for the patient's care. ...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Szylit JA,Grossman ME

    更新日期:1986-05-01 00:00:00

  • Lymphomatoid drug reaction secondary to methylphenidate hydrochloride.

    abstract::Lymphomatoid drug reactions are relatively rare, with no gender, race, or age predilection. The condition generally may be divided into 2 broad categories with some overlap: (1) drug-induced pseudolymphoma and (2) anticonvulsant-induced pseudolymphoma syndrome, marked by the triad of papular to nodular skin lesions, f...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Welsh JP,Ko C,Hsu WT

    更新日期:2008-01-01 00:00:00

  • Amyopathic necrotizing dermatomyositis secondary to an underlying malignancy: a case report and review of the literature.

    abstract::We describe a patient with amyopathic dermatomyositis (DM) secondary to an unusual malignancy. Although the association between amyopathic DM and malignancy has been established, our case report is unique in that the patient exhibited necrotic lesions on her skin. Furthermore, histopathologic examination of the skin l...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Ritchie SA,Kobayashi T,Sperling L

    更新日期:2008-12-01 00:00:00

  • Vacuolar myelinopathy of the brain and lamellar ichthyosis.

    abstract::A 13-month-old child with lamellar ichthyosis and numerous cutaneous and systemic infections died following an abrupt episode of severe hypotension. Postmortem examination revealed white matter vacuolation in the brain stem tegmentum and cerebellar hemispheres similar to that seen in toxicity from hexachlorophene, to ...

    journal_title:Cutis

    pub_type: 杂志文章

    doi:

    authors: Sadick N,Sternberg PE

    更新日期:1986-07-01 00:00:00