omparative Study Between Pulsed and Continuous Itraconazole for the  Treatment of Onychomycosis

Rohida Rahmat; Majid  Hussain; Bushra  Muzaffar; Nadia  Akbar; Muhammad Adeel  Siddique; Kanza  Aftab

doi:10.51253/pafmj.v74i5.9366

Authors

Rohida Rahmat Department of Dermatology, Combined Military Hospital, Abbottabad/National University of Medical Sciences (NUMS) Pakistan
Majid Hussain Department of Dermatology, Combined Military Hospital, Abbottabad/National University of Medical Sciences (NUMS) Pakistan
Bushra Muzaffar Department of Dermatology, Combined Military Hospital, Abbottabad/National University of Medical Sciences (NUMS) Pakistan
Nadia Akbar Department of Dermatology, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Adeel Siddique Department of Dermatology, Combined Military Hospital, Abbottabad/National University of Medical Sciences (NUMS) Pakistan
Kanza Aftab Department of Dermatology, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i5.9366

Keywords:

Continuous Itraconazole Therapy, Fungal Infection, Onychomycosis, OSI (onychomycosis severity index), Pulsed Therapy.

Abstract

Objective: To compare efficacy of pulsed versus continuous daily oral Itraconazole in the treatment of onychomycosis.

Study Design: Randomized Control Trial (ClinicalTrials.gov: NCT05567484).

Place and Duration of Study: Department of Dermatology, Combined Military Hospital, Abbottabad, Pakistan, from May to Dec 2021.

Methodology: We enrolled 60 patients whose toenails showed signs of onychomycosis (crumbling nail plates, thicker nail beds, and yellowing). They were randomly divided into Group-A and Group-B, with 30 patients each. Group -A (Pulse Therapy) took two capsules of oral Itraconazole 100 mg twice weekly for one week every month for three months while Group-B (Continuous Therapy) received continuous oral 100 mg of Itraconazole once daily for 12 weeks continuously. Patients were subjected to an Onychomycosis Severity Index-based clinical evaluation.

Results: In Group-A (Pulse Therapy), 25(83.3%) patients showed mycological cure whereas in Group-B (Continuous Therapy), 23(76.7%) patients showed mycological cure but difference in the efficacy of both drugs was not statistically significant (p-value=0.519).

Conclusion: Pulsed therapy with Itraconazole and continuous Itraconazole therapy have comparable efficacies in treating dermatophyte toenail onychomycosis.

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