Effectiveness and safety of terbinafine for onychomycosis:A systematic review
- VernacularTitle:特比萘芬治疗甲真菌病的系统评价
- Author:
Haibo LIU
;
Fang LIU
;
Hong SANG
- Publication Type:Journal Article
- Keywords:
Terbinafine;
Onychomycosis;
Systematic review;
Randomized controlled trial
- From:
Journal of Medical Postgraduates
2014;(6):608-614
- CountryChina
- Language:Chinese
-
Abstract:
Objective The standard continuous terbinafine regimen (SCTR) is a classical treatment for onychomycosis but has many deficiencies .Therefore, researchers have tried several other therapeutic options .This study systematically evaluated the ef-fectiveness and safety of SCTR versus other therapeutic options in the treatment of onychomycosis . Methods We searched the PubMed, Cochrane Library, Embase, CNKI, CBMdisc and Wanfang databases for the randomized controlled trials on the treatment of onychomycosis with terbinafine .According to the study design , two authors independently selected the literature , extracted data , con-ducted data checking , and then performed meta-analysis. Results Totally, 20 randomized controlled trials were included .The pooled analysis showed that SCTR had a higher long-term mycological cure rate than pulse therapy ( P=0.01, RR=0.81 [0.69, 0.96]), COMBO (P=0.05, RR=0.68 [0.46, 1.01]), and intermittent strategy (P=0.0001, RR=0.81 [0.73, 0.90]). However, SCTR exhibited a lower long-term mycological cure rate than continuous +topical treatment ( P =0.005, RR =1.19 [1.05, 1.35]) and >3 mo continuous therapy (P=0.02, RR=1.12 [1.02, 1.24]).For moderate-to-severe mycological infec-tions, SCTR +aggressive debridement had potential advantages over SCTR alone .Compared with SCTR , continuous +topical treat-ment induced fewer gastrointestinal reactions (P=0.03, RR=0.24 [0.07, 0.90]), and intermittent therapy had lower incidences of adverse events (P=0.03, RR=0.81 [0.67, 0.98]) and taste disorders (P=0.05, RR=0.44 [0.19, 1.00]).Bias risk assess-ment based the tool a domain-based evaluationrecommended by the Cochrane Library found that some high-risk biases in the includ-ed studies might impair the credibility of the results . Conclusion The best terbinafine regimen for onychomycosis remains to be fur-ther investigated with more high-quality randomized controlled trials .
