Clinical Efficacy in the Treatment of Toenail Onychomycosis with Itraconazole 400mg Pulse Therapy: Comparison between Younger Patients and Elderly Patients

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  • Tsunemi Yuichiro
    Department of Dermatology, Faculty of Medicine, University of Tokyo
  • Shimazu Kiyo
    Department of Dermatology, Faculty of Medicine, University of Tokyo
  • Hattori Naoko
    Department of Dermatology, Faculty of Medicine, University of Tokyo Department of Dermatology, Toshiba Hospital
  • Shirai Akira
    Department of Dermatology, Faculty of Medicine, University of Tokyo Department of Dermatology, Kanto Central Hospital
  • Toyama Keiko
    Department of Dermatology, Faculty of Medicine, University of Tokyo
  • Saeki Hidehisa
    Department of Dermatology, Faculty of Medicine, University of Tokyo
  • Komine Mayumi
    Department of Dermatology, Faculty of Medicine, University of Tokyo
  • Tamaki Kunihiko
    Department of Dermatology, Faculty of Medicine, University of Tokyo

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Other Title
  • 趾爪白癬に対するイトラコナゾール400mg パルス療法の臨床効果の検討―60 歳未満群と 65 歳以上群の比較―
  • シツメ ハクセン ニ タイスル イトラコナゾール 400mg パルス リョウホウ ノ リンショウ コウカ ノ ケントウ 60サイ ミマングン ト 65サイ イジョウ グン ノ ヒカク

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Abstract

Onychomycosis is very common in elderly patients. In this study, we evaluated the clinical efficacy and safety of itraconazole 400mg pulse therapy for toenail onychomycosis by comparing patients aged <60 years (younger group) and those 65< years (elderly group). Laboratory examinations were performed before the start of pulse therapy and after each pulse. Reduction of the opacity ratio was examined in patients with big toenail onychomycosis, and clinical safety was assessed in all the patients. Reduction of the opacity ratio at 4,8, 12, 24, and 36 weeks after the start of pulse therapy was 0.40±0.82, 2.64±2.06, 3.68±2.93, 4.40±2.92, and 4.80±3.35 in the younger group and 0.30±0.57, 1.45±1.28, 2.83±1.76, 4.83±2.61, and 5.03±2.77 in the elder group. There were no significant differences between the two groups. Adverse drug reactions were observed in 2 patients (5.4%) in the younger group and 2 patients (6.3%) in the elderly group, but they were mild and improved without treatment after itraconazole was discontinued. The frequency of adverse reactions was not significantly different between the two groups. It appeared that itraconazole 400mg pulse therapy is effective and safe for the elderly patients.

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