Review of the alternative therapies for onychomycosis and superficial fungal infections: posaconazole, fosravuconazole, voriconazole, oteseconazole.

Abstract

Terbinafine and itraconazole are the most commonly used oral antifungals to treat onychomycosis and superficial dermatomycoses. Recently, poor response to oral terbinafine has been reported. We have summarized the most appropriate dosing regimens of posaconazole, fosravuconazole, voriconazole, and oteseconazole (VT-1161) to treat onychomycosis and superficial fungal infections. A structured search on PubMed and Google Scholar was conducted. Additionally, the bibliographies of selected articles were searched to identify relevant records. The number of records identified from the searches was 463, with 50 articles meeting the inclusion criteria for review. None of the new azoles are US FDA approved for onychomycosis treatment; however, an increasing number of studies have evaluated these agents. The efficacies (complete cure and mycologic cure) of the antifungal agents for dermatophyte great toenail onychomycosis treatment are terbinafine 250 mg/day × 12 weeks (Phase III trial) (38%, 70%), itraconazole 200 mg/day × 12 weeks (Phase III trial) (14%, 54%), posaconazole 200 mg/day × 24 weeks (Phase IIB) (54.1%, 70.3%), fosravuconazole 100 mg/day ravuconazole equivalent × 12 weeks (Phase III) (59.4%, 82.0%), and oteseconazole 300 mg/day loading dose × 2 weeks (Phase II), followed by 300 mg/week × 10 weeks (maintenance dose) (45%, 70%). Guidelines for monitoring are also presented.

• Authors: Aditya K Gupta, Mesbah Talukder, Maanasa Venkataraman
• Journal: International journal of dermatology (Int J Dermatol) Vol. 61 Issue 12 Pg. 1431-1441 (Dec 2022) ISSN: 1365-4632 [Electronic] England
• PMID: 34882787 (Publication Type: Journal Article, Review)
• Copyright: © 2021 the International Society of Dermatology.

Chemical References

• Antifungal Agents
• Terbinafine
• Itraconazole
• Voriconazole
• posaconazole
• Naphthalenes
• Dermatologic Agents

Topics

• Humans
• Onychomycosis (drug therapy)
• Antifungal Agents (therapeutic use)
• Terbinafine (therapeutic use)
• Itraconazole (therapeutic use)
• Voriconazole (therapeutic use)
• Foot Dermatoses (drug therapy)
• Naphthalenes (therapeutic use)
• Dermatologic Agents (therapeutic use)
• Complementary Therapies
• Treatment Outcome