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Title: Comparative Study Between Pulsed and Continuous Itraconazole for the Treatment of Onychomycosis
Authors: Rohida Rahmat, Majid Hussain, Bushra Muzaffar, Nadia Akbar, Muhammad Adeel Siddique, Kanza Aftab
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2024
Volume: 74
Issue: 5
Language: English
Keywords: Continuous Itraconazole TherapyFungal InfectionOnychomycosisOSI (onychomycosis severity index)Pulsed Therapy.
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.
To compare the efficacy of pulsed versus continuous daily oral Itraconazole in the treatment of onychomycosis.
Randomized controlled trial conducted at the Department of Dermatology, Combined Military Hospital, Abbottabad, Pakistan, from May to December 2021. Sixty patients with toenail onychomycosis were randomly divided into two groups: Group A (Pulse Therapy) received oral Itraconazole 100 mg twice weekly for one week every month for three months, and Group B (Continuous Therapy) received continuous oral Itraconazole 100 mg once daily for 12 weeks. Patients were evaluated using the Onychomycosis Severity Index.
graph TD
A[Enroll 60 Patients with Onychomycosis] --> B[Randomly Divide into Group A and Group B];
B --> C[Group A: Pulse Therapy Itraconazole];
B --> D[Group B: Continuous Therapy Itraconazole];
C --> E[Administer Treatment];
D --> E;
E --> F[Onychomycosis Severity Index Evaluation];
F --> G[Mycological Cure Assessment];
G --> H[Data Analysis];
H --> I[Conclusion: Compare Efficacy];
The study's findings align with some previous research, indicating comparable efficacy between pulsed and continuous Itraconazole. The results contrast with other studies showing different outcomes.
Mycological cure was observed in 25 (83.3%) patients in Group A (Pulse Therapy) and 23 (76.7%) patients in Group B (Continuous Therapy). The difference in efficacy between the two groups was not statistically significant (p-value = 0.519).
Pulsed therapy with Itraconazole and continuous Itraconazole therapy have comparable efficacies in treating dermatophyte toenail onychomycosis.
1. The study was conducted from May to December 2021. (Confirmed by the Methodology section)
2. Group A received Itraconazole 100 mg twice weekly for one week every month for three months. (Confirmed by the Methodology section)
3. 25 (83.3%) patients in Group A showed mycological cure. (Confirmed by the Results section)
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