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New therapeutic options for onychomycosis.
Aditya K Gupta1, Fiona C Simpson
1Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. agupta@execulink.com
Expert Opinion on Pharmacotherapy
|April 27, 2012
Summary
New treatments for onychomycosis (fungal nail infections) are emerging, including novel topical drugs and device-based therapies. While systemic azoles show promise, terbinafine remains the gold standard for fungal nail infections.
Area of Science:
- Dermatology
- Mycology
- Pharmacology
Background:
- Onychomycosis affects 10-30% of the global population.
- Current treatments have limited efficacy, with high relapse and reinfection rates (20-25%).
- There is a need for improved therapeutic options for fungal nail infections.
Purpose of the Study:
- To review emerging pharmacotherapeutics for onychomycosis.
- To discuss novel device-based treatment options for fungal nail infections.
- To evaluate the efficacy of new and existing onychomycosis treatments.
Main Methods:
- Review of emerging pharmacotherapies including terbinafine reformulations, new azoles, benzoxaboroles, and polymer barriers.
- Discussion of device-based options like photodynamic therapy, iontophoresis, and laser systems.
- Analysis of current treatment efficacy and future directions for onychomycosis management.
Main Results:
- Device-based therapies for onychomycosis are rapidly advancing.
- Systemic azoles demonstrate efficacy comparable to systemic terbinafine.
- New topical agents include tavaborole, efinaconazole, and luliconazole.
Conclusions:
- Terbinafine remains the gold standard for onychomycosis treatment.
- Emerging topical drugs and device-based therapies show potential but require further study.
- Randomized controlled trials are needed to confirm the long-term efficacy of device-based treatments.
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