• 1

    Gupta AK, Jain H, 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. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Elewski BE, Charif MA: Prevalence of onychomycosis in patients attending a dermatology clinic in northeastern Ohio for other conditions. .Arch Dermatol 133::1172. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Ciclopirox lacquer topical solution 8% [package insert], Aventis Pharmaceuticals, Inc, Collegeville, PA, December 1999..

  • 4

    Gupta AK, Fleckman P, Baran R: Ciclopirox nail lacquer topical solution 8% in the treatment of toenail onychomycosis. .J Am Acad Dermatol 43 (suppl 4)::S70. ,2000. .

    • Search Google Scholar
    • Export Citation
  • 5

    Gupta AK: Pharmacoeconomic analysis of ciclopirox nail lacquer solution 8% and the new oral antifungal agents used to treat dermatophyte toe onychomycosis in the United States. .J Am Acad Dermatol 43 (suppl 4)::S81. ,2000. .

    • Search Google Scholar
    • Export Citation
  • 6

    Gupta AK: Pharmacoeconomic analysis of oral antifungal therapies used to treat dermatophyte onychomycosis of the toenails: a US analysis. .Pharmacoeconomics 13::243. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Arikian SR, Einarson TR, Kobelt-Nguyen G, et al: A multinational pharmacoeconomic analysis of oral therapies for onychomycosis. .Br J Dermatol 130 (suppl 43)::35. ,1994. .

    • Search Google Scholar
    • Export Citation
  • 8

    Van Doorslaer EKA, Tormans G, Gupta AK, et al: Economic evaluation of antifungal agents in the treatment of toenail onychomycosis in Germany. .Dermatology 193::239. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Gupta AK, Sauder DN, Shear NH: Antifungal agents: an overview: part I. .J Am Acad Dermatol 30::677. ,1994. .

  • 10

    Gupta AK, Sauder DN, Shear NH: Antifungal agents: an overview: part II. .J Am Acad Dermatol 30::911. ,1994. .

  • 11

    Tosti A, Piraccini BM, Lorenzi S: Onychomycosis caused by nondermatophytic molds: clinical features and response to treatment of 59 cases. .J Am Acad Dermatol 42::217. ,2000. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Gupta AK, Shear NH: The new oral agents for onychomycosis of the toenails. .J Eur Acad Dermatol Venereol 13::1. ,1999. .

  • 13

    Gupta AK, Shear NH: An update, with a risk-benefit evaluation of the newer oral antifungal agents to treat onychomycosis. .Drug Safety 22::33. ,2000. .

  • 14

    Tosti A, Piraccini BM, Stinchi C, et al: Treatment of dermatophyte nail infections: an open randomized study comparing intermittent terbinafine therapy with continuous terbinafine treatment and intermittent itraconazole therapy. .J Am Acad Dermatol 34::595. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Alpsoy E, Yilmaz E, Basaran E: Intermittent therapy with terbinafine for dermatophyte toe-onychomycosis: an open randomized study comparing intermittent terbinafine therapy with continuous terbinafine treatment and intermittent itraconazole therapy. .J Dermatol 23::259. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Gupta AK, Lynde CW, Konnikov N: Single blind randomized study of sequential itraconazole and terbinafine pulse compared with terbinafine pulse for the treatment of toenail onychomycosis. .J Am Acad Dermatol 44::485. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Arenas R, Fernandez G, Dominguez L: Onychomycosis treated with itraconazole or griseofulvin alone with and without a topical antimycotic or keratolytic agent. .Int J Dermatol 30::586. ,1991. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Baran R, Belaich S, Beylot C, et al: Comparative multicenter double-blind study of terbinafine (250 mg per day) versus griseofulvin (1 g per day) in the treatment of dermatophyte onychomycosis. .J Dermatol Treatment 8::93. ,1997. .

    • Search Google Scholar
    • Export Citation
  • 19

    Faergemann J, Anderson C, Hersle K, et al: Double-blind, parallel-group comparison of terbinafine and griseofulvin in the treatment of toenail onychomycosis. .J Am Acad Dermatol 32::750. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Hofmann J, Bräutigam M, Weidinger G, et al: Treatment of toenail onychomycosis: a randomized, double-blind study with terbinafine and griseofulvin. .Arch Dermatol 131::919. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    WalsØe I, Stangerup M, Svejgaard E: Itraconazole in onychomycosis: open and double-blind studies. .Acta Derm Venereol 70::137. ,1990. .

  • 22

    Arenas R, Dominguez-Cherit J, Fernández LM: Open randomized comparison of itraconazole versus terbinafine in onychomycosis. .Int J Dermatol 34::138. ,1993. .

    • Search Google Scholar
    • Export Citation
  • 23

    Bräutigam M, Nolting S, Schopf RE, et al: Randomized double blind comparison of terbinafine and itraconazole for treatment of toenail tinea infection. .Br Med J 311::919. ,1995. .

    • Search Google Scholar
    • Export Citation
  • 24

    De Backer M, De Keyser P, De Vroey C, et al: A 12-week treatment for dermatophyte toe onychomycosis: terbinafine 250 mg/day vs. itraconazole 200 mg/day: a double-blind comparative trial. .Br J Dermatol 134 (suppl 46)::16. ,1996. .

    • Search Google Scholar
    • Export Citation
  • 25

    Degreef HJ, Dejgaard J, Del Palacio A, et al: Randomized double-blind comparison of short term itraconazole and terbinafine therapy for toenail onychomycosis. .Acta Derm Venereol 79::221. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Elewski BE, Scher RK, Aly R, et al: Double-blind, randomized comparison of itraconazole capsules vs. placebo in the treatment of toenail onychomycosis. .Cutis 59::217. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Haneke E, Delescluse J, Plinck E, et al: The use of itraconazole in onychomycosis. .Eur J Dermatol 6::7. ,1996. .

  • 28

    Havu V, Brandt H, Heikkilä H, et al: A double-blind, randomized study comparing itraconazole pulse therapy with continuous dosing for the treatment of toe-nail onychomycosis. .Br J Dermatol 136::230. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Honeyman JF, Talarico FS, Arruda LHF, et al: Itraconazole versus terbinafine (LAMISIL): which is better for the treatment of onychomycosis. ?J Eur Acad Dermatol 9::215. ,1997. .

    • Search Google Scholar
    • Export Citation
  • 30

    Jones HE, Zaias N: Double-blind, randomized comparison of itraconazole capsules and placebo in the treatment of onychomycosis of the toenail. .Int J Dermatol 35::589. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Odom R, Daniel R, Aly R: A double blind randomized comparison of itraconazole capsules and placebo in the treatment of onychomycosis of the toenail. .J Am Acad Dermatol 35::110. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Itraconazole Product Monograph, Janssen Pharmaceutica Inc, Titusville, NJ, 1996..

  • 33

    Bonifaz A, Carrasco-Gerard E, Saúl A: Itraconazole in onychomycosis: intermittent dose schedule. .Int J Dermatol 36::70. ,1997. .

  • 34

    Gupta AK, Maddin S, Arlette J, et al: Itraconazole pulse therapy is effective in dermatophyte onychomycosis of the toenail: a double-blind placebo-controlled study. .J Dermatol Treatment 11::33. ,2000. .

    • Search Google Scholar
    • Export Citation
  • 35

    Evans EG, Sigurgeirsson B, for the LION Study Group: Double-blind randomized study of continuous terbinafine compared with intermittent itraconazole in the treatment of toenail onychomycosis. .BMJ 318::1031. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Ginter G, De Doncker P: An intermittent 1-week dosing regimen for the treatment of toenail onychomycosis in dermatological patients. .Mycoses 41::235. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    Haneke E, Abeck D, Ring J: The safety and efficacy of intermittent therapy with itraconazole for finger- and toenail onychomycosis: a multicenter trial. .Zeitschrift fuer Hautkrankheiten 10::737. ,1997. .

    • Search Google Scholar
    • Export Citation
  • 38

    Haneke E, Tajerbashi M, De Doncker P, et al: Itraconazole in the treatment of onychomycosis: a double-blind comparison with miconazole. .Dermatology 196::323. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39

    Kejda J: Itraconazole pulse therapy vs. continuous terbinafine dosing for toenail onychomycosis. .Postgrad Med (spec no)::12. ,1999. .

  • 40

    Negroni R, Avechvala A, Bonvehi P: Treatment of onychomycosis due to mycelial fungi. .Revista Argentina de Micologica 21::8. ,1998. .

  • 41

    Svejgaard E: “Poster P 206.” Presented at the Fifty-sixth Annual Meeting of the American Academy of Dermatology, February 27–March 4, 1998, Orlando, FL..

  • 42

    Wang DL, Wang AP, Li RY, et al: Therapeutic efficacy and safety of 1-week intermittent therapy with itraconazole for onychomycosis in a Chinese patient population. .Dermatology 199::47. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43

    De Backer M, De Keyser P, Massart DL, et al: “Terbinafine (Lamisil) 250 mg/day and 500 mg/day Are Equally Effective in a 16 Week Oral Treatment of Toenail Onychomycosis: A Double-Blind Multicentre Trial,” in International Perspective on Lamisil, ed by RJ Hay, p 39, CCT Healthcare Communications, London, 1994..

  • 44

    Goodfield MJD, Andrew L, Evans EGV: Short term treatment of dermatophyte onychomycosis with terbinafine. .BMJ 304::1151. ,1992. .

  • 45

    Havu V, Heikkila H, Kuokkanen K, et al: A double-blind, randomized study to compare the efficacy and safety of terbinafine (Lamisil) with fluconazole (Diflucan) in the treatment of onychomycosis. .Br J Dermatol 142::97. ,2000. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46

    Pollack R, Billstein SA: Efficacy of terbinafine for toenail onychomycosis: a multicenter trial of various treatment durations. .JAPMA 91::127. ,2001. .

    • Search Google Scholar
    • Export Citation
  • 47

    Svejgaard EL, Brandrup F, Kragballe K, et al: Oral terbinafine in toenail dermatophytosis. .Acta Derm Venereol 77::66. ,1997. .

  • 48

    Tausch I, Bräutigam M, Weidinger G, et al: Evaluation of 6 weeks treatment of terbinafine in tinea unguium in a double-blind trial comparing 6 and 12 weeks therapy. .Br J Dermatol 136::737. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 49

    Terbinafine [package insert], Novartis Pharmaceuticals Corp, East Hanover, NJ, 1996..

  • 50

    Van Der Schroeff JG, Cirkel PK, et al: A randomized treatment duration-finding study of terbinafine in onychomycosis. .Br J Dermatol 126::36. ,1992. .

  • 51

    Watson A, Marley J, Ellis D, et al: Terbinafine in onychomycosis of the toenail: a novel treatment protocol. .J Am Acad Dermatol 33::775. ,1995. .

  • 52

    Fräki J, Heikkilä H, Kero M, et al: An open-label, non-comparative, multicenter evaluation of fluconazole with or without urea nail pedicure for treatment of onychomycosis. .Curr Ther Res 58::481. ,1997. .

    • Search Google Scholar
    • Export Citation
  • 53

    Montero-Gei F, Robles-Soto ME, Schlager H: Fluconazole in the treatment of severe onychomycosis. .Int J Dermatol 35::587. ,1996. .

  • 54

    Scher RK, Breman D, Rich P, et al: Once-weekly fluconazole (150 mg, 300 mg, or 450 mg) in the treatment of distal subungual onychomycosis of the toenail. .J Am Acad Dermatol 38::S77. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 55

    Goldfarb NJ, Sulzberger MB: Experiences in one hundred thirty-seven patients with oral griseofulvin. .Arch Dermatol 81::859. ,1960. .

  • 56

    Kaminsky A: Comparative effects of griseofulvin on onychomycosis and on psoriasis. .Arch Dermatol 60::838. ,1960. .

  • 57

    Williams DI: Griseofulvin and Trichophyton rubrum infections. .Arch Dermatol 81::769. ,1960. .

  • 58

    Davies RR, Everall JD, Hamilton E: Mycological and clinical evaluation of griseofulvin for chronic onychomycosis. .BMJ 3::464. ,1967. .

  • 59

    Korting HC, Schafer-Korting M, Zienicke H, et al: Treatment of tinea unguium with medium and high doses of ultramicrosize griseofulvin compared with that with itraconazole. .Antimicrob Agents Chemother 37::2064. ,1993. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 60

    Russell B, Frain-Bell W, Riddell RW, et al: Chronic ringworm infection of the skin and nails treated with griseofulvin. .Lancet 1::1140. ,1960. .

    • Search Google Scholar
    • Export Citation
  • 61

    Hay RJ, Clayton YM, Griffiths WA, et al: A comparative double-blind study of ketoconazole and griseofulvin in dermatophytosis. .Br J Dermatol 112::691. ,1985. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 62

    Piepponen T, Blomqvist K, Brandt H, et al: Efficacy and safety of itraconazole in the long-term treatment of onychomycosis. .J Antimicrob Chemother 29::195. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 63

    Stevenson CJ, Djavahizwili N: Chronic ringworm of the nails. .Lancet 1::373. ,1961. .

  • 64

    Levin H, Alden HS, Ajello L: Use of griseofulvin in office practice. .Arch Dermatol 81::827. ,1960. .

  • 65

    Quintaville P: Onychomycosis treated with ultrafine griseofulvin. .JAPA 56::119. ,1966. .

  • 66

    Dillaha CJ, Jansen GT: Dosage requirements of griseofulvin in onychomycosis due to Trichophyton rubrum. .Arch Dermatol 81::192. ,1960. .

    • Search Google Scholar
    • Export Citation
  • 67

    Blank H, Smith GJ, Roth FJ, et al: Griseofulvin for the systemic treatment of dermatomycoses. .JAMA 171::2168. ,1959. .

  • 68

    Maibach HI, Klingman AM: Short-term treatment of onychomycosis with griseofulvin. .Arch Dermatol 18::733. ,1960. .

  • 69

    González-Ochoa A, Ahumada-Padilla M: New schemes in the treatment of dermatophytoses with griseofulvin. .Arch Dermatol 81::833. ,1960. .

  • 70

    Haneke E, Tausch I, Bräutigam M, et al: Short-duration treatment of fingernail dermatophytosis: a randomized, double-blind study with terbinafine and griseofulvin. .J Am Acad Dermatol 32::72. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 71

    Hargreaves GK: The treatment of onychomycosis with griseofulvin. .Br J Dermatol 72::358. ,1960. .

  • 72

    André J, De Doncker P, Laporet M, et al: Onychomycosis caused by Microsporum canis: treatment with itraconazole. .J Am Acad Dermatol 32::1052. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 73

    Hanifin JM, Tofte SJ: Itraconazole therapy for recalcitrant dermatophyte infections. .J Am Acad Dermatol 18::1077. ,1988. .

  • 74

    Rongioletti F, Robert E, Tripodi S, et al: Treatment of onychomycosis with itraconazole. .J Dermatol Treatment 2::145. ,1992. .

  • 75

    Stary A, Storch M, Hörting-Müller I: Systemic treatment of onychomycosis with itraconazole: clinical and mycological results [abstract]. Presented at the Third Congress of the European Academy of Dermatology and Venereology, September 26–30, 1993, Copenhagen..

  • 76

    Hay RJ, Clayton YM, Moore MK, et al: An evaluation of itraconazole in the management of onychomycosis. .Br J Dermatol 119::359. ,1988. .

  • 77

    DePadova-Elder SM, Ditre CM, Kantor GR, et al: Candidiasis endocrinopathy syndrome. .Arch Dermatol 130::19. ,1994. .

  • 78

    Kim JA, Ahn KJ, Kim JM, et al: Efficacy and tolerability of itraconazole in patients with fingernail onychomycosis: a 6-week pilot study. .Curr Ther Res 56::1066. ,1995. .

    • Search Google Scholar
    • Export Citation
  • 79

    De Doncker PRG, Scher RK, Baran RL, et al: Itraconazole therapy is effective for pedal onychomycosis caused by some non-dermatophyte molds and in mixed infection with dermatophytes and molds: a multicenter study with 35 patients. .J Am Acad Dermatol 36::173. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 80

    Hay RJ, Baran R, Moore MK, et al: Candida onychomycosis: an evaluation of the role of Candida species in nail disease. .Br J Dermatol 118::47. ,1988. .

  • 81

    Kirshbaum BA: Itraconazole therapy for onychomycosis: case reports. .Cutis 58::371. ,1996. .

  • 82

    Tosti A, Piraccini BM, Vincenzi C, et al: Itraconazole in the treatment of two young brothers with chronic mucocutaneous candidiasis. .Pediatr Dermatol 14::146. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 83

    Willemsen M, De Doncker P, Willems J, et al: Posttreatment itraconazole levels in the nail. .J Am Acad Dermatol 26::731. ,1992. .

  • 84

    Havu V, Brandt H, Heikkila H, et al: Continuous and intermittent itraconazole dosing schedules for the treatment of onychomycosis: a pharmacokinetic comparison. .Br J Dermatol 140::96. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 85

    De Doncker P, Decroix J, Pierard GE, et al: Itraconazole pulse therapy is effective in the treatment of onychomycosis: a pharmacokinetic/pharmacodynamic and clinical evaluation. .Arch Dermatol 132::34. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 86

    Gupta AK, Scher RK, De Doncker P: Current management of onychomycosis: an overview. .Dermatol Clin 15::121. ,1997. .

  • 87

    De Doncker P, Van Lint J, Dockx P, et al: Pulse therapy with one-week itraconazole monthly for three or four months in the treatment of onychomycosis. .Cutis 56::180. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 88

    Wu J, Wen H, Liao W: Small-dose itraconazole pulse therapy in the treatment of onychomycosis. .Mycoses 40::397. ,1997. .

  • 89

    Ramos-e-Silva M, Marques SA, Gontijo B, et al: Efficacy and safety of itraconazole pulse therapy: Brazilian multicentric study on toenail onychomycosis caused by dermatophytes. .J Eur Acad Dermatol Venereol 11::109. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 90

    Luyton C, André J, Walraevens C, et al: Yellow nail syndrome and onychomycosis. .Dermatology 192::406. ,1996. .

  • 91

    Elewski BE: Trichophyton rubrum onychomycosis in a 17-year-old girl. .Cutis 60::253. ,1997. .

  • 92

    Odom RB, Aly R, Scher RK, et al: A multicenter, placebo-controlled, double-blind study of intermittent therapy with itraconazole for the treatment of onychomycosis of the fingernail. .J Am Acad Dermatol 36::231. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 93

    Chen J, Liao W, Wen H, et al: A comparison among four regimens of itraconazole treatment in onychomycosis. .Mycoses 42::93. ,1999. .

  • 94

    Albreski DA, Gross EG: The safety of itraconazole in the diabetic population. .JAPMA 89::339. ,1999. .

  • 95

    Gupta AK, Konnikov N, Lynde CW: Single-blind, randomized, prospective study on terbinafine and itraconazole for treatment of dermatophyte toenail onychomycosis in the elderly. .J Am Acad Dermatol 44::479. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 96

    Huang PH, Paller AS: Itraconazole pulse therapy for dermatophyte onychomycosis in children. .Arch Pediatr Adolesc Med 154::614. ,2000. .

  • 97

    Gupta AK, Nolting S, de Prost Y, et al: The use of itraconazole to treat cutaneous fungal infections in children. .Dermatology 199::248. ,1999. .

  • 98

    Gupta AK, Adam P, Hofstader SL: Itraconazole oral solution for the treatment of onychomycosis. .Pediatr Dermatol 15::472. ,1998. .

  • 99

    Gupta AK, Sibbald RG, Lynde CW, et al: Onychomycosis in children: prevalence and treatment strategies. .J Am Acad Dermatol 36::395. ,1997. .

  • 100

    Zaias N, Rebell G: Onychomycosis treated until the nail is replaced by normal growth or there is failure. .Arch Dermatol 136::940. ,2000. .

    • Search Google Scholar
    • Export Citation
  • 101

    Galimberti R, Kowalczuk A, Flores V, et al: Onychomycosis treated with a short course of oral terbinafine. .Int J Dermatol 35::374. ,1996. .

  • 102

    Albanese G, Di Cintio R, Martini C, et al: Short therapy for tinea unguium with terbinafine: four different courses of treatment. .Mycoses 38::211. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 103

    Rakosi T: Terbinafine and onychomycosis [abstract]. .Dermatologica 181::174. ,1990. .

  • 104

    Shuster S, Munro C: Single dose treatment of fungal nail disease [letter]. .Lancet 339::1066. ,1992. .

  • 105

    Zaias N: Management of onychomycosis with oral terbinafine. .J Am Acad Dermatol 23::810. ,1990. .

  • 106

    Baudraz-Rosselet F, Rakosi T, Wili PB, et al: Treatment of onychomycosis with terbinafine. .Br J Dermatol 126::40. ,1992. .

  • 107

    Goodfield MJD, Rowell NR, Forster RA, et al: Treatment of dermatophyte infection of the finger- and toe-nails with terbinafine (SF 86-327, Lamisil), an orally active fungicidal agent. .Br J Dermatol 121::753. ,1989. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 108

    Goodfield MJD: Short-duration therapy with terbinafine for dermatophyte onychomycosis: a multicentre trial. .Br J Dermatol 126::33. ,1992. .

  • 109

    Goodfield MJD: Clinical results with terbinafine in onychomycosis. .J Dermatol Treatment 1::55. ,1990. .

  • 110

    Zaias N, Serrano L: The successful treatment of finger Trichophyton rubrum onychomycosis with oral terbinafine. .Clin Exp Dermatol 14::120. ,1989. .

  • 111

    Savin RC, Atton AV: Terbinafine in onychomycosis: a mini study. .Int J Dermatol 32::918. ,1993. .

  • 112

    Eastcott DF: Terbinafine and onychomycosis [letter]. .N Z Med J 104::17. ,1991. .

  • 113

    Wong CK, Cho YL: Very short duration therapy with oral terbinafine for fingernail onychomycosis. .Br J Dermatol 133::329. ,1995. .

  • 114

    Nolting S, Bräutigam M, Weidinger G: Terbinafine in onychomycosis with involvement by non-dermatophytic fungi. .Br J Dermatol 130::16. ,1994. .

  • 115

    Segal R, Kritzman A, Cividalli L, et al: Treatment of Candida nail infections with terbinafine. .J Am Acad Dermatol 35::958. ,1996. .

  • 116

    Roberts DT, Richardson MD, Dwyer PK, et al: Terbinafine in chronic paronychia and Candida onychomycosis. .J Dermatol Treatment 3::39. ,1992. .

    • Search Google Scholar
    • Export Citation
  • 117

    Tosti A, Piraccini BM, Stinchi C, et al: Onychomycosis due to Scopulariopsis brevicaulis: clinical features and response to systemic antifungals. .Br J Dermatol 135::799. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 118

    Lee KH, Kim YS, Kim MS, et al: Study of the efficacy and tolerability of oral terbinafine in the treatment of onychomycosis in renal transplant patients. .Transplant Proc 28::1488. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 119

    Velthuis PJ, Nijenhuis M: Treatment of onychomycosis with terbinafine in patients with Down’s syndrome. .Br J Dermatol 133::144. ,1995. .

    • Search Google Scholar
    • Export Citation
  • 120

    Török I, Simon G, Dobozy A, et al: Long-term post-treatment follow-up of onychomycosis treated with terbinafine: a multicentre trial. .Mycoses 41::63. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 121

    Nandwani R, Parnell A, Youle M, et al: Use of terbinafine in HIV-positive subjects: pilot studies in onychomycosis and oral candidiasis. .Br J Dermatol 134::22. ,1996. .

    • Search Google Scholar
    • Export Citation
  • 122

    Herranz P, García J, De Lucas R, et al: Toenail onychomycosis in patients with acquired immune deficiency syndrome: treatment with terbinafine. .Br J Dermatol 137::577. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 123

    Billstein S, Kianifard F, Justice A: Terbinafine vs. placebo for onychomycosis in black patients. .Int J Dermatol 38::377. ,1999. .

  • 124

    Smith EB, Stein LF, Fivenson DP, et al: The safety of terbinafine in patients over the age of 60 years: a multicenter trial in onychomycosis of the feet. .Int J Dermatol 39::861. ,2000. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 125

    Ungpakorn R, Reangchainam S, Kullavanijaya P: Onychomycosis in a 2-year-old child successfully treated with oral terbinafine. .J Am Acad Dermatol 39::654. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 126

    Gupta AK, Scher RK, Rich P: Fluconazole for the treatment of onychomycosis: an update. .Int J Dermatol 37::815. ,1998. .

  • 127

    Kuokkanen K, Alava S: Fluconazole in the treatment of onychomycosis caused by dermatophytes. .J Dermatol Treatment 3::115. ,1992. .

  • 128

    Drake L, Babel D, Stewart DM, et al: Once-weekly fluconazole (150, 300, or 450 mg) in the treatment of distal subungual onychomycosis of the fingernail. .J Am Acad Dermatol 38::S87. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 129

    Ling MR, Swinyer LJ, Jarratt MT, et al: Once-weekly fluconazole (450 mg) for 4, 6, or 9 months of treatment for distal subungual onychomycosis of the toenail. .J Am Acad Dermatol 38::S95. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 130

    Rich P, Scher RK, Breneman D, et al: Pharmacokinetics of three doses of once-weekly fluconazole (150, 300, and 450 mg) in distal subungual onychomycosis of the toenail. .J Am Acad Dermatol 38::S103. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 131

    Savin RC, Drake L, Babel D, et al: Pharmacokinetics of three once-weekly dosages of fluconazole (150, 300, or 450 mg) in distal subungual onychomycosis of the fingernail. .J Am Acad Dermatol 38::S110. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 132

    Assaf RR, Elewski BE: Intermittent fluconazole dosing in patients with onychomycosis: results of a pilot study. .J Am Acad Dermatol 35::216. ,1996. .

  • 133

    Aihara Y, Mori M, Yokota S: Successful treatment of onychomycosis with fluconazole in two patients with hyperimmunoglobulin E syndrome. .Pediatr Dermatol 13::493. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 134

    Smith SW, Sealy DP, Schneider E, et al: An evaluation of the safety and efficacy of fluconazole in the treatment of onychomycosis. .South Med J 88::1217. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 135

    Coldiron B: Recalcitrant onychomycosis of the toenails successfully treated with fluconazole. .Arch Dermatol 28::909. ,1992. .

  • 136

    Nahass GT, Sisto M: Onychomycosis: successful treatment with once-weekly fluconazole. .Dermatology 186::59. ,1993. .

  • 137

    Hochman LG, Scher RK, Meyerson MS, et al: The safety and efficacy of oral fluconazole in the treatment of onychomycosis. .J Geriatr Dermatol 1::169. ,1993. .

    • Search Google Scholar
    • Export Citation
  • 138

    DerSimonian R, Laird NM: Meta-analysis in clinical trials. .Control Clin Trials 7::177. ,1986. .

  • 139

    Velanovich V: Meta-analysis for combining Bayesian probabilities. .Med Hypotheses 35::192. ,1991. .

  • 140

    Villars VV, Jones TC: Special features of the clinical use of oral terbinafine in the treatment of fungal diseases. .Br J Dermatol 126 (suppl 39)::61. ,1992. .

    • Search Google Scholar
    • Export Citation
  • 141

    De Doncker P, Gupta AK, Marynissen G, et al: Itraconazole pulse therapy for onychomycosis and dermatomycoses: an overview. .J Am Acad Dermatol 37::969. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 142

    Elewski BE: Once-weekly fluconazole in the treatment of onychomycosis. .J Am Acad Dermatol 38::S77. ,1998. .

  • 143

    Drug Topics Red Book: Pharmacy’s Fundamental Reference, p 1, Medical Economics Co, Montvale, NJ, 2000..

  • 144

    Health Care Financing Administration: 1995 Annual Medicare Physician Fee Schedule: Carrier File, Empire New York Carrier, Baltimore, 1995..

  • 145

    Health Care Financing Administration: 1995 Clinical Diagnostic Lab Fee Schedule: Carrier File, Empire New York Carrier, Baltimore, 1995..

  • 146

    Gupta AK, Lambert J: Pharmacoeconomic analysis of the new oral antifungal agents used to treat toenail onychomycosis in the USA. .Int J Dermatol 38 (suppl 2)::53. ,1999. .

    • Search Google Scholar
    • Export Citation
  • 147

    Katz HI, Gupta AK: Oral antifungal drug interactions. .Dermatol Clin 15::535. ,1997. .

  • 148

    Gupta AK, Katz HI, Shear NH: Drug interactions with itraconazole, fluconazole and terbinafine, and their management. .J Am Acad Dermatol 41::237. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 149

    Gupta AK: Onychomycosis in the elderly. .Drugs Aging 16::397. ,2000. .

  • 150

    Gupta AK, Baran R: Ciclopirox nail lacquer solution 8% in the 21st century. .J Am Acad Dermatol 43::S96. ,2000. .

  • 151

    Ahmad SR, Singer SJ, Leissa BG: Congestive heart failure associated with itraconazole. .Lancet 357::1766. ,2001. .

Treatment of Dermatophyte Toenail Onychomycosis in the United States

A Pharmacoeconomic Analysis

Aditya K. Gupta Associate Professor, Division of Dermatology, Department of Medicine, Sunnybrook and Women’s College Health Sciences Center (Sunnybrook campus) and University of Toronto, Toronto, Ontario, Canada. Mailing address:490 Wonderland Rd S, Ste 6, London, Ontario, Canada N6K 1L6.

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This study attempted to determine the cost-effectiveness of therapies for dermatophyte toenail onychomycosis in the United States in 2001. The antimycotic agents evaluated were ciclopirox 8% nail lacquer and the oral agents terbinafine, itraconazole (pulse), itraconazole (continuous), fluconazole, and griseofulvin. A treatment algorithm for the management of onychomycosis was developed, and a meta-analysis was carried out to determine the average mycologic and clinical response rates for the various agents. The cost of the regimen was figured as the sum of the costs of drug acquisition, medical management, and management of adverse effects. The expected cost of management and disease-free days were determined, and a sensitivity analysis was conducted. It was concluded that ciclopirox 8% nail lacquer, which has recently become available in the larger size of 6.6 mL, is a cost-effective agent for the management of toenail onychomycosis. (J Am Podiatr Med Assoc 92(5): 272-286, 2002)

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