How effective is efinaconazole in the management of onychomycosis?

ABSTRACT

Introduction: Onychomycosis is a fungal nail infection that is difficult to treat due to poor accessibility of drugs into the nail plate. Although oral antifungals can reach the nail apparatus more readily, these therapies may not be suitable or desirable for some patients (e.g., multiple medications or immunocompromised). Efinaconazole 10% solution is a new topical antifungal recently approved and sold in Canada, the United States and Japan for the treatment of mild-to-moderate toenail onychomycosis. Efinaconazole has broad-spectrum antifungal activity against dermatophytes, nondermatophyte molds and yeasts, and high ungual penetration due to its low keratin binding properties.

Areas covered: The objective of this article is to summarize recent data regarding the efficacy, safety and pharmacokinetic properties of efinaconazole in the treatment of onychomycosis.

Expert opinion: Efinaconazole is a safe and effective treatment for onychomycosis that can be used in a wide range of patients due to its broad-spectrum antifungal activity andlow rate of treatment-related adverse events. When incomplete response to oral therapy or devices (e.g. laser therapy) is encountered, efinaconazole could be used in combination to improve success rates. Alternatively, efinaconazole could be used as a ‘closer’ drug, in an effort to provide cure when the initial oral or device therapy has resulted in an incomplete response.

KEYWORDS:

• Efinaconazole
• Jublia
• toenail
• fungal infection
• tinea unguium

Declaration of Interest

AK Gupta has served as a clinical trials investigator and/ or speaker for Valeant Pharmaceuticals, Inc., Bristol Meyers Squibb, Inc., Novartis, Inc., Janssen Pharmaceuticals, Inc., Bayer, Inc., and Anacor. M Cernea is employed by Mediprobe Research, Inc., which conducts the clinical trials under the supervision of AK Gupta. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.