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-
1
Scher RK, Coppa LM: Advances in the diagnosis and treatment of onychomycosis. Hosp Med 34: 11, 1998.
-
2
Gupta AK, Jain HC, Lynde CW, et al: Prevalence and epidemiology of onychomycosis in patients visiting physicians' offices: a multicenter Canadian survey of 15,000 patients. J Am Acad Dermatol 43: 244, 2000.
-
3
Crissey JT: Common dermatophyte infections: a simple diagnostic test and current management. Postgrad Med 103: 191, 1998.
-
4
Elewski BE: Onychomycosis: treatment, quality of life, and economic issues. Am J Clin Dermatol 1: 19, 2000.
-
5
Niewerth M, Korting HC: Management of onychomycoses. Drugs 58: 285, 1999.
-
6
Drake LA, Patrick DL, Fleckman P, et al: The impact of onychomycosis on quality of life: development of an international onychomycosis-specific questionnaire to measure patient quality of life. J Am Acad Dermatol 1: 189, 1999.
-
7
Seebacher C, Brasch J, Abeck D, et al: Onychomycosis. Mycoses 50: 321, 2007.
-
8
Iorizzo M, Piraccini BM, Tosti A: Today's treatments options for onychomycosis. J Dtsch Dermatol Ges 8: 875, 2010.
-
9
Tatsumi Y, Nagashima M, Shibanushi T, et al: Mechanism of antifungal action of efinaconazole, a novel triazole agent. Antimicrob Agents Chemother 57: 2405, 2013.
-
10
Loo DS: Onychomycosis in the elderly: drug treatment options. Drugs Aging 24: 293, 2007.
-
11
Foster KW, Ghannoum MA, Elewski BE: Epidemiologic surveillance of cutaneous fungal infection in the United States from 1999 to 2002. J Am Acad Dermatol 50: 748, 2004.
-
12
Vender RB, Lynde CW, Poulin Y: Prevalence and epidemiology of onychomycosis. J Cutan Med Surg 10 (suppl 2): S28, 2006.
-
13
Gupta AK, Drummond-Main C, Cooper EA, et al: Systematic review of nondermatophyte mold onychomycosis: diagnosis, clinical types, epidemiology, and treatment. J Am Acad Dermatol 66: 494, 2012.
-
14
Jo Siu WJ, Tatsumi Y, Senda H, et al: Comparison of in vitro antifungal activities of efinaconazole and currently available antifungal agents against a variety of pathogenic fungi associated with onychomycosis. Antimicrob Agents Chemother 57: 1610, 2013.
-
15
Pfaller MA: Antifungal drug resistance: mechanisms, epidemiology, and consequences for treatment. Am J Med 125 (suppl 1): S3, 2012.
-
16
Howard SJ, Cerar D, Anderson MJ, et al: Frequency and evolution of azole resistance in Aspergillus fumigatus associated with treatment failure. Emerg Infect Dis 15: 1068, 2009.
-
17
Martinez-Rossi NM, Peres NT, Rossi A: Antifungal resistance mechanisms in dermatophytes. Mycopathologia 166: 369, 2008.
-
18
Mukherjee PK, Leidich SD, Isham N, et al: Clinical Trichophyton rubrum strain exhibiting primary resistance to terbinafine. Antimicrob Agents Chemother 47: 82, 2003.
-
19
Iwata A, Watanabe Y, Kumagai N, et al: In vitro and in vivo assessment of dermatophyte acquired resistance to efinaconazole, a novel triazole antifungal. Antimicrob Agents Chemother 58: 3837, 2014.
-
20
Sugiura K, Sugimoto N, Hosaka S, et al: Efinaconazole: low keratin affinity contributes to nail penetration and fungicidal activity in topical onychomycosis treatment. Antimicrob Agents Chemother 58: 3837, 2014.
-
21
Gupta AK, Joseph WS: Ciclopirox 8% nail lacquer in the treatment of onychomycosis of the toenails in the United States. JAPMA 90: 495, 2000.
-
22
Bohn M, Kraemer K: The dermatopharmacologic profile of ciclopirox 8% nail lacquer. JAPMA 90: 491, 2000.
-
23
Tatsumi Y, Yokoo M, Arika, T, et al: In vitro antifungal activity of KP-103, a novel triazole derivative, and its therapeutic efficacy against experimental plantar tinea pedis and cutaneous candidiasis in guinea pigs. Antimicrob Agents Chemother 45: 1493, 2001.
-
24
Elewski BE, Rich P, Pollak R, et al: Efinaconazole 10% solution in the treatment of toenail onychomycosis: two phase 3 multicenter, randomized, double-blind studies. J Am Acad Dermatol 68: 600, 2013.
-
25
Gupta AK, Fleckman P, Baran R: Ciclopirox nail lacquer topical solution 8% in the treatment of toenail onychomycosis. J Am Acad Dermatol 43: S70, 2000.
-
26
Anacor Pharmaceuticals announces positive results from the second phase 3 trial of tavaborole for onychomycosis [press release]. Palo Alto, CA: Anacor Pharmaceuticals; February 28, 2013.
-
27
Werschler WP, Bondar G, Armstrong D: Assessing treatment outcomes in toenail onychomycosis clinical trials. Am J Clin Dermatol 5: 145, 2004.
-
28
Gupta AK: Treatment of dermatophyte toenail onychomycosis in the United States: a pharmacoeconomic analysis. JAPMA 92: 272, 2002.
-
29
Young M: Onychomycosis: Burden of illness and successful treatment with a new topical antifungal. J Dermatol Nurs Assoc 6: 239, 2014.
-
30
Gupta AK, Elewski BE, Sugarman JL, et al: The efficacy and safety of efinaconazole 10% solution in the treatment of mild to moderate onychomycosis: a pooled anaylsis of two phase 3 randomized trials. J Drugs Dermatol 13: 815, 2014.
-
31
Baran R, Tosti A, Hartmane I, et al: An innovative water-soluble biopolymer improves efficacy of ciclopirox nail lacquer in the management of onychomycosis. J Eur Acad Dermatol Venereol 23: 773, 2009.
-
32
Sigurgeirsson B, Billstein S, Rantanen T, et al: LION Study: efficacy and tolerability of continuous terbinafine (Lamisil) compared to intermittent itraconazole in the treatment of toenail onychomycosis: Lamisil vs itraconazole in onychomycosis. Br J Dermatol 141 (suppl): 5, 1999.
-
33
Elewski BE, Ghannoum MA, Mayser P, et al: Efficacy, safety and tolerability of topical terbinafine nail solution in patients with mild-to-moderate toenail onychomycosis: results from three randomized studies using double-blind vehicle-controlled and open-label active-controlled designs. J Eur Acad Dermatol Venereol 27: 287, 2013.
-
34
Bhatt V, Sarpotdar P, Pillai R, et al: Development of an optimal formulation for efinaconazole a novel antifungal agent for the treatment of onychomycosis by topical application. Poster presented at: 71st Annual Meeting of the American Academy of Dermatology; March 1–5, 2013; Miami Beach, FL.
-
35
Sporanox (itraconazole) [prescribing information]. Titusville, NJ: Janssen; 2012.
-
36
Piraccini BM, Sisti A, Tosti A: Long-term follow-up of toenail onychomycosis caused by dermatophytes after successful treatment with systemic antifungal agents. J Am Acad Dermatol 62: 411, 2010.
Efinaconazole Topical Solution, 10%
The Development of a New Topical Treatment for Toenail Onychomycosis
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Background
Toenail onychomycosis is a common disease with limited treatment options; treatment failure and relapse are frequently encountered. Many patients experience long-standing disease affecting multiple toenails, with substantial discomfort and pain. Although some patients might prefer a topical therapy, efficacy with ciclopirox nail lacquer has been disappointing.
Methods
Efinaconazole topical solution, 10% is the first topical triazole antifungal agent specifically developed for the treatment of onychomycosis. This paper reviews the preclinical and clinical data on efinaconazole topical solution, 10%.
Results
Efinaconazole has a broad spectrum of antifungal activity in vitro and is more potent than ciclopirox against common onychomycosis pathogens. It has a more optimal keratin affinity than ciclopirox, and it exhibits significantly greater in vivo activity owing to its superior nail penetration. Mycologic cure rates at week 52 were 55.2% (study 1) and 53.4% (study 2) with efinaconazole topical solution, 10% compared with 16.8% and 16.9%, respectively, with vehicle (P<.001 for both). In addition, efinaconazole is well tolerated.
Conclusions
Efinaconazole topical solution, 10% may likely become a preferred topical agent for the management of mild-to-moderate onychomycosis.
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