Systemic therapy of onychomycosis of the feet with terbinafine: dynamics of nail rehabilitation and quality of life

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Abstract

BACKGROUND: Systemic therapy with terbinafine (Exifin®) forms the basis of any treatment programs for onychomycosis of the feet of dermatomycete etiology. At the same time, the available literature presents relatively little data on the efficacy and safety of systemic terbinafine drugs for individual age groups; and there are practically no such studies based on a large statistical sample with a simultaneous assessment of the dynamics of the quality of life indicator.

AIMS: To study the use of the drug Exifin ® tablets in certain age groups of patients with mycosis and onychomycosis in clinical practice.

MATERIALS AND METHODS: The study was a multicenter observational (non-interventional) study involving 1602 patients with varying degrees of severity of onychomycosis of the feet/hands. The patients were divided into 4 age groups, each of which was divided into subgroups according to the severity of onychomycosis, from very mild to extremely severe. The positive dynamics of regression of symptoms, improvement of the quality of life according to the survey scale, the presence or absence of significant adverse reactions were evaluated.

RESULTS: In all 1602 patients, positive dynamics from the skin process was obtained in the form of regression of onychomycosis symptoms. The best results on the speed of nail sanitization were obtained in more “young” age groups with a mild degree of onychomycosis. The lowest rate of regrowth of a healthy nail plate was observed in the age groups 45–60 years and over 60 years. In the same age groups, the greatest number of persistent onychodystrophy remained after the eradication of the fungus. In all age groups, there was a positive trend in the quality of life: at the end of treatment, 67% of patients rated the quality of life as “excellent” and “good”, and another 24.1% ― “satisfactory”. No adverse events were recorded in any clinical case.

CONCLUSION: Systemic therapy with terbinafine in onychomycosis of the feet/hands is a highly effective component in the combination treatment, allowing to achieve eradication of the fungus in 85–90% of cases.

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About the authors

Alexander B. Yakovlev

Central State Medical Academy of Department of Presidential Affairs

Author for correspondence.
Email: aby@rinet.ru
ORCID iD: 0000-0001-7073-9511

MD, PhD, Docent, Department of Dermatovenerology and Cosmetology

Russian Federation, 10, 2nd Frunzenskaya street, 119146 Moscow

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Supplementary files

Supplementary Files
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1. Fig. 1. Marginal lesion with onychomycosis incipient («saw» symptom). Clinical index for assessing the severity of Sergeyev’s onychomycosis (CIASOS) = 3. Own observation.

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2. Fig. 2. Normotrophic type of lesion of the nail plates of the feet in onychomycosis caused by Trichophyton rubrum. CIASOS = 12. Own observation.

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3. Fig. 3. Hypertrophic type of onychomycosis (pseudoonychogryphosis). CIASOS = 24. Own observation.

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4. Fig. 4. White superficial type of onychomycosis caused by fungi Fusarium. CIASOS = 2. Own observation.

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5. Fig. 5. Age groups of patients in the study.

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6. Fig. 6. Assessment of the mycological symptoms severity according to the CIASOS scale.

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7. Fig. 7. Distribution of onychomycosis of the feet and hands by severity before the start of treatment.

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8. Fig. 8. Localization of mycotic lesions.

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9. Fig. 9. Evaluation of the severity of mycological symptoms according to the CIASOS scale by 90th and 120/150th days of treatment.

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10. Fig. 10. Formed (as the nail grows) demarcation zone as a result of combination therapy with Exifin®. Own observation.

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11. Fig. 11. Assessment of the quality of life of patients by 90th and 120/150th days of treatment.

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