FLORENCE, ITALY — Terbinafine can cure onychomycosis in patients who take it for only 1 week every 2–3 months for up to a year, Martin N. Zaias, M.D., reported at 13th Congress of the European Academy of Dermatology and Venereology.
“From an economic point of view, our concern was that if a patient is taking a daily dose for 3 months, the cost is obviously going to be greater than taking a daily dose just 1 week of every 2 or 3 months,” said Dr. Zaias, in private practice in Miami.
He noted that earlier studies by his group confirmed that terbinafine (Lamisil) remains in the nail bed for at least a month after being taken for 7 consecutive days at a 250-mg/day dosage.
Pulse dosing using a 1-week-per-month schedule became an accepted way to treat Trichophyton rubrum onychomycosis.
The current study was aimed at seeing how far that limit could be stretched.
“If 1 week out of the month worked, why not 1 week out of every 2 months … or 3 months … or 4?” he asked.
Nine of 10 patients recruited from Dr. Zaias's practice were cured within a year after taking the medication for 1 week every 2 months at the standard dosage of 250 mg/day. Twelve of 12 patients were cured taking terbinafine for 1 week every 3 months.
When the 1-week pulse was extended to every 4 months, however, the cure rate dropped to 10 of 17 patients tested.
The researchers monitored patients' progress by measuring the extent of involvement on the nail bed from a scalpel nick placed at the onset of the trial.