Efinaconazole effective in treating pediatric toenail onychomycosis
Pediatric patients with toenail onychomycosis who were treated with efinaconazole 10% had higher cure rates and negative fungal cultures compared with other treatments, according to a poster at Maui Derm for Dermatologists.
“Children may be easier to treat than adults due to shorter nail length, faster nail growth and/or shorter duration of disease,” Richard Scher, MD, and colleagues wrote in the poster presentation. “Treatments approved in the U.S. for pediatric patients are the topicals efinaconazole 10% (approved for use in patients 6 years of age), tavaborole 5% (6 years of age) and ciclopirox 8% (12 years of age).”
Scher and colleagues reviewed the results of three clinical studies that investigated the efficacy of efinaconazole, tavaborole and ciclopirox in pediatric patients. Participants in the efinaconazole and tavaborole trials were aged 6 to 16 years, and participants in the ciclopirox study were aged 2 to 16 years. All participants received treatment once daily. The efinaconazole and tavaborole studies administered treatment for 48 weeks, with a follow-up at 52 weeks, and the ciclopirox study administered treatment for 32 weeks. Mycologic cure, complete cure and complete/almost complete cure as well as negative fungal culture were assessed.
Efinaconazole had the highest rates of each endpoint including mycologic cure (65% vs. tavaborole, 36.2%), complete cure (40% vs. tavaborole, 8.5%; ciclopirox, 34.2%), complete/almost complete cure (41.7% vs. tavaborole, 14.9%) and negative fungal culture (88.3% vs. tavaborole, 87.2%; ciclopirox, 77.1%). Researchers wrote that the ciclopirox study defined mycologic cure as “negative fungal culture” and did not report complete/almost complete cure rate.
“Overall, these pediatric data align with a recent Cochrane review of treatments for adult onychomycosis, which found that high-quality evidence supports the effectiveness of efinaconazole for complete cure, moderate-quality evidence supports tavaborole and low-quality evidence supports ciclopirox lacquer,” the researchers wrote.