Welcome to the Pharmacy Read List! The Read List is a biweekly update on pharmaceutical literature. Every two weeks we handpick one of the most relevant and interesting pharmacy-related publications and summarize it for your convenience. At the end of every month, a quiz on that month’s content will be released. Simply take the quiz, and you’ll be automatically entered into a draw for a gift card prize! Not only do you get to expand your knowledge of our field from reading, but you also get the chance to win a prize! For this edition comes an article on our old friend onychomycosis.
The efficacy and safety of efinaconazole 10% solution for treatment of mild to moderate onychomycosis: a pooled analysis of two phase 3 randomized trials
Instructions to access: Use your CWL login to access the UBC Library link. If that does not work try using UBC Summons with the article title copy and pasted into the search field. Onychomycosis is a fungal infection of fingernail or toenail that has been difficult to treat topically due to the poor penetration of existing antifungal agents through the nail. Efinaconazole 10% solution (brand: Jublia) is one of the newer topical antifungal agents that has just been approved for the sale and patient use this summer. As the title suggests, this particular study is the pooled analysis of the two separate Phase III trials of this drug to look at the efficacy and safety of efinaconazole 10% topical solution for mild to moderate fungal infection of nail in comparison to the vehicle control. The study was double-blinded and randomized (to 3:1 ratio of treatment: control).* The primary endpoint for the efficacy was the complete cure of toenail from fungal infection 4 weeks after 48 weeks of once-daily treatment, which was statistically higher for the patients who received 10% efinaconazole solution. Interestingly, the efficacy of efinaconazole was higher in female compared to male, and also for onychomycosis with less than 33% involvement compared to more severe onychomycosis. In terms of safety, most adverse effects were mild (local irritation) and did not statisitcally differ from the vehicle, although the percentage of adverse effects as well as discontinuation were slightly higher. Overall, this study suggests that 10% efinaconazole topical solution is a safe topical antifungal agent that appears to be promising for the treatment of mild to moderate fungal nail infection, although it should be noted that this study is limited to 48 weeks + 4 weeks post follow up and the efficacy and safety against other available topical and oral agents are to be investigated.
– Yohan Choi
B.Sc. (Pharm) Candidate 2016