Topical treatment effective for toenail fungal infection

(HealthDay)—Once daily topical efinaconazole is effective in treating fungal infections of the toenail, according to a study published in the April issue of the Journal of the American Academy of Dermatology.

As part of two studies, Boni E. Elewski, M.D., from the University of Alabama at Birmingham School of Medicine, and colleagues randomized 870 patients (first study) and 785 patients (second study) with toenail distal lateral subungual onychomycosis in a 3:1 ratio to efinaconazole (10 percent solution) or vehicle once a day for 48 weeks. Participants were followed up at four weeks post-treatment.

At week 52, the researchers found that the mycologic cure rate was significantly higher for patients treated with efinaconazole (55.2 versus 16.8 percent for study 1; 53.4 versus 16.9 percent for study 2). The complete cure rate (defined as no clinical involvement of the target toenail, negative potassium hydroxide examination, and negative fungal culture) was also significantly higher in the efinaconazole group (17.8 versus 3.3 percent for study 1; 15.2 versus 5.5 percent for study 2). Treatment success (< 10 percent clinical involvement) was also achieved in significantly more patients treated with efinaconazole (35.7 versus 11.7 percent for study 1; 31.0 versus 11.9 percent for study 2). The rate of adverse events was similar for the efinaconazole and vehicle groups, according to the study.

"Once daily topical efinaconazole appears to be a viable alternative to oral treatment options for onychomycosis," Elewski and colleagues conclude.

The study was funded by Valeant Pharmaceuticals North America LLC, which manufactures efinaconazole. Several authors are employees of and/or disclosed financial relationships with pharmaceutical companies, including Valeant.

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