Treatment of dermatophyte toenail onychomycosis in the United States: A pharmacoeconomic analysis

Journal of the American Podiatric Medical Association

Volumn 92, Issue 5, 2002, Pages 272-286

  Gupta, Aditya K ^a,b  

^a UNIVERSITY OF TORONTO   (Canada)

^b NONE   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIFUNGAL AGENT; CICLOPIROX; GRISEOFULVIN; ITRACONAZOLE; NAPHTHALENE DERIVATIVE; PYRIDONE DERIVATIVE; TERBINAFINE;

ARTICLE; CLINICAL TRIAL; COMPARATIVE STUDY; DRUG COST; ECONOMICS; HUMAN; META ANALYSIS; ONYCHOMYCOSIS; SKIN DISEASE; TOPICAL DRUG ADMINISTRATION; UNITED STATES;

ADMINISTRATION, TOPICAL; ANTIFUNGAL AGENTS; DRUG COSTS; FOOT DERMATOSES; GRISEOFULVIN; HUMANS; ITRACONAZOLE; NAPHTHALENES; ONYCHOMYCOSIS; PYRIDONES; UNITED STATES;

EID: 0036584667     PISSN: 87507315     EISSN: None     Source Type: Journal    
DOI: 10.7547/87507315-92-5-272     Document Type: Review

References (151)

1. GUPTA AK, JAIN H, LYNDE CW, ET AL: Prevalence and epidemiology of onychomycosis in patients visiting physicians' offices: a multicenter Canadian survey of 15,000 patients. J Am Acad Dermatol 43: 244, 2000.
2. ELEWSKI BE, CHARIF MA: Prevalence of onychomycosis in patients attending a dermatology clinic in northeastern Ohio for other conditions. Arch Dermatol 133: 1172, 1997.
3. Ciclopirox lacquer topical solution 8% [package insert], Aventis Pharmaceuticals, Inc, Collegeville, PA, December 1999.
4. GUPTA AK, FLECKMAN P, BARAN R: Ciclopirox nail lacquer topical solution 8% in the treatment of toenail onychomycosis. J Am Acad Dermatol 43 (suppl 4): S70, 2000.
5. GUPTA AK: Pharmacoeconomic analysis of Ciclopirox nail lacquer solution 8% and the new oral antifungal agents used to treat dermatophyte toe onychomycosis in the United States. J Am Acad Dermatol 43 (suppl 4): S81, 2000.
6. GUPTA AK: Pharmacoeconomic analysis of oral antifungal therapies used to treat dermatophyte onychomycosis of the toenails: a US analysis. Pharmacoeconomics 13: 243, 1998.
7. ARIKIAN SR, EINARSON TR, KOBELT-NGUYEN G, ET AL: A multinational pharmacoeconomic analysis of oral therapies for onychomycosis. Br J Dermatol 130 (suppl 43): 35, 1994.
8. VAN DOORSLAER EKA, TORMANS G, GUPTA AK, ET AL: Economic evaluation of antifungal agents in the treatment of toenail onychomycosis in Germany. Dermatology 193: 239, 1996.
9. GUPTA AK, SAUDER DN, SHEAR NH: Antifungal agents: an overview: part I. J Am Acad Dermatol 30: 677, 1994.
10. GUPTA AK, SAUDER DN, SHEAR NH: Antifungal agents: an overview: part II. J Am Acad Dermatol 30: 911, 1994.
11. TOSTI A, PIRACCINI BM, LORENZI S: Onychomycosis caused by nondermatophytic molds: clinical features and response to treatment of 59 cases. J Am Acad Dermatol 42: 217, 2000.
12. GUPTA AK, SHEAR NH: The new oral agents for onychomycosis of the toenails. J Eur Acad Dermatol Venereol 13: 1, 1999.
13. GUPTA AK, SHEAR NH: An update, with a risk-benefit evaluation of the newer oral antifungal agents to treat, onychomycosis. Drug Safety 22: 33, 2000.
14. TOSTI A, PIRACCINI BM, STINCHI C, ET AL: Treatment of dermatophyte nail infections: an open randomized study comparing intermittent terbinafine therapy with continuous terbinafine treatment and intermittent itraconazole therapy. J Am Acad Dermatol 34: 595, 1996.
15. ALPSOY E, YILMAZ E, BASARAN E: Intermittent therapy with terbinafine for dermatophyte toe-onychomycosis: an open randomized study comparing intermittent terbinafine therapy with continuous terbinafine treatment and intermittent itraconazole therapy. J Dermatol 23: 259, 1996.
16. GUPTA AK, LYNDE CW, KONNIKOV N: Single blind randomized study of sequential itraconazole and terbinafine pulse compared with terbinafine pulse for the treatment of toenail onychomycosis. J Am Acad Dermatol 44: 485, 2001.
17. ARENAS R, FERNANDEZ G, DOMINGUEZ L: Onychomycosis treated with itraconazole or griseofulvin alone with and without a topical antimycotic or keratolytic agent. Int J Dermatol 30: 586, 1991.
18. BARAN R, BELAICH S, BEYLOT C, ET AL: Comparative multicenter double-blind study of terbinafine (250 mg per day) versus griseofulvin (1 g per day) in the treatment of dermatophyte onychomycosis. J Dermatol Treatment 8: 93, 1997.
19. FAERGEMANN J, ANDERSON C, HERSLE K, ET AL: Double-blind, parallel-group comparison of terbinafine and griseofulvin in the treatment of toenail onychomycosis. J Am Acad Dermatol 32: 750, 1995.
20. HOFMANN J, BRÄUTIGAM M, WEIDINGER G, ET AL: Treatment of toenail onychomycosis: a randomized, double-blind study with terbinafine and griseofulvin. Arch Dermatol 131: 919, 1995.
21. WALSOE I, STANGERUP M, SVEJGAARD E: Itraconazole in onychomycosis: open and double-blind studies. Acta Derm Venereol 70: 137, 1990.
22. ARENAS R, DOMINGUEZ-CHERIT J, FERNÁNDEZ LM: Open randomized comparison of itraconazole versus terbinafine in onychomycosis. Int J Dermatol 34: 138, 1993.
23. BRÄUTIGAM M, NOLTING S, SCHOPF RE, ET AL: Randomized double blind comparison of terbinafine and itraconazole for treatment of toenail tinea infection. Br Med J 311: 919, 1995.
24. DE BACKER M, DE KEYSER P, DE VROEY C, ET AL: A 12-week treatment for dermatophyte toe onychomycosis: terbinafine 250 mg/day vs. itraconazole 200 mg/day: a double-blind comparative trial. Br J Dermatol 134 (suppl 46): 16, 1996.
25. DEGREEF HJ, DEJGAARD J, DEL PALACIO A, ET AL: Randomized double-blind comparison of short term itraconazole and terbinafine therapy for toenail onychomycosis. Acta Derm Venereol 79: 221, 1999.
26. ELEWSKI BE, SCHER RK, ALY R, ET AL: Double-blind, randomized comparison of itraconazole capsules vs. placebo in the treatment of toenail onychomycosis. Cutis 59: 217, 1997.
27. HANEKE E, DELESCLUSE J, PLINCK E, ET AL: The use of itraconazole in onychomycosis. Eur J Dermatol 6: 7, 1996.
28. HAVU V, BRANDT H, HEIKKILÄ H, ET AL: A double-blind, randomized study comparing itraconazole pulse therapy with continuous dosing for the treatment of toenail onychomycosis. Br J Dermatol 136: 230, 1997.
29. HONEYMAN JF, TALARICO FS, ARRUDA LHF, ET AL: Itraconazole versus terbinafine (LAMISIL): which is better for the treatment of onychomycosis? J Eur Acad Dermatol 9: 215, 1997.
30. JONES HE, ZAIAS N: Double-blind, randomized comparison of itraconazole capsules and placebo in the treatment of onychomycosis of the toenail. Int J Dermatol 35: 589, 1996.
31. ODOM R, DANIEL R, ALY R: A double blind randomized comparison of itraconazole capsules and placebo in the treatment of onychomycosis of the toenail. J Am Acad Dermatol 35: 110, 1996.
32. Itraconazole Product Monograph, Janssen Pharmaceutica Inc, Titusville, NJ, 1996.
33. BONIFAZ A, CARRASCO-GERARD E, SAÚL A: Itraconazole in onychomycosis: intermittent dose schedule. Int J Dermatol 36: 70, 1997.
34. GUPTA AK, MADDIN S, ARLETTE J, ET AL: Itraconazole pulse therapy is effective in dermatophyte onychomycosis of the toenail: a double-blind placebo-controlled study. J Dermatol Treatment 11: 33, 2000.
35. EVANS EG, SIGURGEIRSSON B, FOR THE LION STUDY GROUP: Double-blind randomized study of continuous terbinafine compared with intermittent itraconazole in the treatment of toenail onychomycosis. BMJ 318: 1031, 1999.
36. GINTER G, DE DONCKER P: An intermittent 1-week dosing regimen for the treatment of toenail onychomycosis in dermatological patients. Mycoses 41: 235, 1998.
37. HANEKE E, ABECK D, RING J: The safety and efficacy of intermittent therapy with itraconazole for finger- and toenail onychomycosis: a multicenter trial. Zeitschrift fuer Hautkrankheiten 10: 737, 1997.
38. HANEKE E, TAJERBASHI M, DE DONCKER P, ET AL: Itraconazole in the treatment of onychomycosis: a double-blind comparison with miconazole. Dermatology 196: 323, 1998.
39. KEJDA J: Itraconazole pulse therapy vs. continuous terbinafine dosing for toenail onychomycosis. Postgrad Med (spec no): 12, 1999.
40. NEGRONI R, AVECHVALA A, BONVEHI P: Treatment of onychomycosis due to mycelial fungi. Revista Argentina de Micologica 21: 8, 1998.
41. SVEJGAARD E: "Poster P 206." Presented at the Fifty-sixth Annual Meeting of the American Academy of Dermatology, February 27-March 4, 1998, Orlando, FL.
42. WANG DL, WANG AP, LI RY, ET AL: Therapeutic efficacy and safety of 1-week intermittent therapy with itraconazole for onychomycosis in a Chinese patient population. Dermatology 199: 47, 1999.
43. DE BACKER M, DE KEYSER P, MASSART DL, ET AL: "Terbinafine (Lamisil) 250 mg/day and 500 mg/day Are Equally Effective in a 16 Week Oral Treatment of Toenail Onychomycosis: A Double-Blind Multicentre Trial," in International Perspective on Lamisil, ed by RJ Hay, p 39, CCT Healthcare Communications, London, 1994.
44. GOODFIELD MJD, ANDREW L, EVANS EGV: Short term treatment of dermatophyte onychomycosis with terbinafine. BMJ 304: 1151, 1992.
45. HAVU V, HEIKKILA H, KUOKKANEN K, ET AL: A double-blind, randomized study to compare the efficacy and safety of terbinafine (Lamisil) with fluconazole (Diflucan) in the treatment of onychomycosis. Br J Dermatol 142: 97, 2000.
46. POLLACK R, BILLSTEIN SA: Efficacy of terbinafine for toenail onychomycosis: a multicenter trial of various treatment durations. JAPMA 91: 127, 2001.
47. SVEJGAARD EL, BRANDRUP F, KRAGBALLE K, ET AL: Oral terbinafine in toenail dermatophytosis. Acta Derm Venereol 77: 66, 1997.
48. TAUSCH I, BRÄUTIGAM M, WEIDINGER G, ET AL: Evaluation of 6 weeks treatment of terbinafine in tinea unguium in a double-blind trial comparing 6 and 12 weeks therapy. Br J Dermatol 136: 737, 1997.
49. Terbinafine [package insert], Novartis Pharmaceuticals Corp, East Hanover, NJ, 1996.
50. VAN DER SCHROEFF JG, CIRKEL PK, ET AL: A randomized treatment duration-finding study of terbinafine in onychomycosis. Br J Dermatol 126: 36, 1992.
51. WATSON A, MARLEY J, ELLIS D, ET AL: Terbinafine in onychomycosis of the toenail: a novel treatment protocol. J Am Acad Dermatol 33: 775, 1995.
52. FRAKI J, HEIKKILÄ H, KERO M, ET AL: An open-label, non-comparative, multicenter evaluation of fluconazole with or without urea nail pedicure for treatment of onychomycosis. Curr Ther Res 58: 481, 1997.
53. MONTERO-GEI F, RODLES-SOTO ME, SCHLAGER H: Fluconazole in the treatment of severe onychomycosis. Int J Dermatol 35: 587, 1996.
54. SCHER RK, BREMAN D, RICH P, ET AL: Once-weekly fluconazole (150 mg, 300 mg, or 450 mg) in the treatment of distal subungual onychomycosis of the toenail. J Am Acad Dermatol 38: S77, 1998.
55. GOLDFARB NJ, SULZBERGER MB: Experiences in one hundred thirty-seven patients with oral griseofulvin. Arch Dermatol 81: 859, 1960.
56. KAMINSKY A: Comparative effects of griseofulvin on onychomycosis and on psoriasis. Arch Dermatol 60: 838, 1960.
57. WILLIAMS DI: Griseofulvin and Trichophyton rubrum infections. Arch Dermatol 81: 769, 1960.
58. DAVIES RR, EVERALL JD, HAMILTON E: Mycological and clinical evaluation of griseofulvin for chronic onychomycosis. BMJ 3: 464, 1967.
59. KORTING HC, SCHAFER-KORTING M, ZIENICKE H, ET AL: Treatment of tinea unguium with medium and high doses of ultramicrosize griseofulvin compared with that with itraconazole. Antimicrob Agents Chemother 37: 2064, 1993.
60. RUSSELL B, FRAIN-BELL W, RIDDELL RW, ET AL: Chronic ringworm infection of the skin and nails treated with griseofulvin. Lancet 1: 1140, 1960.
61. HAY RJ, CLAYTON YM, GRIFFITHS WA, ET AL: A comparative double-blind study of ketoconazole and griseofulvin in dermatophytosis. Br J Dermatol 112: 691, 1985.
62. PIEPPONEN T, BLOMQVIST K, BRANDT H, ET AL: Efficacy and safety of itraconazole in the long-term treatment of onychomycosis. J Antimicrob Chemother 29: 195, 1992.
63. STEVENSON CJ, DJAVAHIZWILI N: Chronic ringworm of the nails. Lancet 1: 373, 1961.
64. LEVIN H, ALDEN HS, AJELLO L: Use of griseofulvin in office practice. Arch Dermatol 81: 827, 1960.
65. QUINTAVILLE P: Onychomycosis treated with ultrafine griseofulvin. JAPA 56: 119, 1966.
66. DILLAHA CJ, JANSEN GT: Dosage requirements of griseofulvin in onychomycosis due to Trichophyton rubrum. Arch Dermatol 81: 192, 1960.
67. BLANK H, SMITH GJ, ROTH FJ, ET AL: Griseofulvin for the systemic treatment of dermatomycoses. JAMA 171: 2168, 1959.
68. MAIBACH HI, KLINGMAN AM: Short-term treatment of onychomycosis with griseofulvin. Arch Dermatol 18: 733, 1960.
69. GONZÁLEZ-OCHOA A, AHUMADA-PADILLA M: New schemes in the treatment of dermatophytoses with griseofulvin. Arch Dermatol 81: 833, 1960.
70. HANEKE E, TAUSCH I, BRÄUTIGAM M, ET AL: Short-duration treatment of fingernail dermatophytosis: a randomized, double-blind study with terbinafine and griseofulvin. J Am Acad Dermatol 32: 72, 1995.
71. HARGREAVES GK: The treatment of onychomycosis with griseofulvin. Br J Dermatol 72: 358, 1960.
72. ANDRÉ J, DE DONCKER P, LAPORET M, ET AL: Onychomycosis caused by Microsporum canis: treatment with itraconazole. J Am Acad Dermatol 32: 1052, 1995.
73. HANIFIN JM, TOFTE SJ: Itraconazole therapy for recalcitrant dermatophyte infections. J Am Acad Dermatol 18: 1077, 1988.
74. RONGIOLETTI F, ROBERT E, TRIPODI S, ET AL: Treatment of onychomycosis with itraconazole. J Dermatol Treatment 2: 145, 1992.
75. STARY A, STORCH M, HÖRTING-MÜLLER I: Systemic treatment of onychomycosis with itraconazole: clinical and mycological results [abstract]. Presented at the Third Congress of the European Academy of Dermatology and Venereology, September 26-30, 1993, Copenhagen.
76. HAY RJ, CLAYTON YM, MOORE MK, ET AL: An evaluation of itraconazole in the management of onychomycosis. Br J Dermatol 119: 359, 1988.
77. DEPADOVA-ELDER SM, DITRE CM, KANTOR GR, ET AL: Candidiasis endocrinopathy syndrome. Arch Dermatol 130: 19, 1994.
78. KIM JA, AHN KJ, KIM JM, ET AL: Efficacy and tolerability of itraconazole in patients with fingernail onychomycosis: a 6-week pilot study. Curr Ther Res 56: 1066, 1995.
79. DE DONCKER PRG, SCHER RK, BARAN RL, ET AL: Itraconazole therapy is effective for pedal onychomycosis caused by some non-dermatophyte molds and in mixed infection with dermatophytes and molds: a multicenter study with 35 patients. J Am Acad Dermatol 36: 173, 1997.
80. HAY RJ, BARAN R, MOORE MK, ET AL: Candida onychomycosis: an evaluation of the role of Candida species in nail disease. Br J Dermatol 118: 47, 1988.
81. KIRSHBAUM BA: Itraconazole therapy for onychomycosis: case reports. Cutis 58: 371, 1996.
82. TOSTI A, PIRACCINI BM, VINCENZI C, ET AL: Itraconazole in the treatment of two young brothers with chronic mucocutaneous candidiasis. Pediatr Dermatol 14: 146, 1997.
83. WILLEMSEN M, DE DONCKER P, WILLEMS J, ET AL: Post-treatment itraconazole levels in the nail. J Am Acad Dermatol 26: 731, 1992.
84. HAVU V, BRANDT H, HEIKKILA H, ET AL: Continuous and intermittent itraconazole dosing schedules for the treatment of onychomycosis: a pharmacokinetic comparison. Br J Dermatol 140: 96, 1999.
85. DE DONCKER P, DECROIX J, PIERARD GE, ET AL: Itraconazole pulse therapy is effective in the treatment of onychomycosis: a pharmacokinetic/pharmacodynamic and clinical evaluation. Arch Dermatol 132: 34, 1996.
86. GUPTA AK, SCHER RK, DE DONCKER P: Current management of onychomycosis: an overview. Dermatol Clin 15: 121, 1997.
87. DE DONCKER P, VAN LINT J, DOCKX P, ET AL: Pulse therapy with one-week itraconazole monthly for three or four months in the treatment of onychomycosis. Cutis 56: 180, 1995.
88. Wu J, WEN H, LIAO W: Small-dose itraconazole pulse therapy in the treatment of onychomycosis. Mycoses 40: 397, 1997.
89. RAMOS-E-SILVA M, MARQUES SA, GONTIJO B, ET AL: Efficacy and safety of itraconazole pulse therapy: Brazilian multicentric study on toenail onychomycosis caused by dermatophytes. J Eur Acad Dermatol Venereol 11: 109, 1998.
90. LUYTON C, ANDRÉ J, WALRAEVENS C, ET AL: Yellow nail syndrome and onychomycosis. Dermatology 192: 406, 1996.
91. ELEWSKI BE: Trichophyton rubrum onychomycosis in a 17-year-old girl. Cutis 60: 253, 1997.
92. ODOM RB, ALY R, SCHER RK, ET AL: A multicenter, placebo-controlled, double-blind study of intermittent therapy with itraconazole for the treatment of onychomycosis of the fingernail. J Am Acad Dermatol 36: 231, 1997.
93. CHEN J, LIAO W, WEN H, ET AL: A comparison among four regimens of itraconazole treatment in onychomycosis. Mycoses 42: 93, 1999.
94. ALBRESKI DA, GROSS EG: The safety of itraconazole in the diabetic population. JAPMA 89: 339, 1999.
95. GUPTA AK, KONNIKOV N, LYNDE CW: Single-blind, randomized, prospective study on terbinafine and itraconazole for treatment of dermatophyte toenail onychomycosis in the elderly. J Am Acad Dermatol 44: 479, 2001.
96. HUANG PH, PALLER AS: Itraconazole pulse therapy for dermatophyte onychomycosis in children. Arch Pediatr Adolesc Med 154: 614, 2000.
97. GUPTA AK, NOLTING S, DE PROST Y, ET AL: The use of itraconazole to treat cutaneous fungal infections in children. Dermatology 199: 248, 1999.
98. GUPTA AK, ADAM P, HOFSTADER SL: Itraconazole oral solution for the treatment of onychomycosis. Pediatr Dermatol 15: 472, 1998.
99. GUPTA AK, SIBBALD RG, LYNDE CW, ET AL: Onychomycosis in children: prevalence and treatment strategies. J Am Acad Dermatol 36: 395, 1997.
100. ZAIAS N, REBELL G: Onychomycosis treated until the nail is replaced by normal growth or there is failure. Arch Dermatol 136: 940, 2000.
101. GALIMBERTI R, KOWALCZUK A, FLORES V, ET AL: Onychomycosis treated with a short course of oral terbinafine. Int J Dermatol 35: 374, 1996.
102. ALBANESE G, DI CINTIO R, MARTINI C, ET AL: Short therapy for tinea unguium with terbinafine: four different courses of treatment. Mycoses 38: 211, 1995.
103. RAKOSI T: Terbinafine and onychomycosis [abstract]. Dermatologica 181: 174, 1990.
104. SHUSTER S, MUNRO C: Single dose treatment of fungal nail disease [letter]. Lancet 339: 1066, 1992.
105. ZAIAS N: Management of onychomycosis with oral terbinafine. J Am Acad Dermatol 23: 810, 1990.
106. BAUDRAZ-ROSSELET F, RAKOSI T, WILI PB, ET AL: Treatment of onychomycosis with terbinafine. Br J Dermatol 126: 40, 1992.
107. GOODFIELD MJD, ROWELL NR, FORSTER RA, ET AL: Treatment of dermatophyte infection of the finger- and toenails with terbinafine (SF 86-327, Lamisil), an orally active fungicidal agent. Br J Dermatol 121: 753, 1989.
108. GOODFIELD MJD: Short-duration therapy with terbinafine for dermatophyte onychomycosis: a multicentre trial. Br J Dermatol 126: 33, 1992.
109. GOODFIELD MJD: Clinical results with terbinafine in onychomycosis. J Dermatol Treatment 1: 55, 1990.
110. ZAIAS N, SERRANO L: The successful treatment of finger Trichophyton rubrum onychomycosis with oral terbinafine. Clin Exp Dermatol 14: 120, 1989.
111. SAVIN RC, ATTON AV: Terbinafine in onychomycosis: a mini study. Int J Dermatol 32: 918, 1993.
112. EASTCOTT DF: Terbinafine and onychomycosis [letter]. N Z Med J 104: 17, 1991.
113. WONG CK, CHO YL: Very short duration therapy with oral terbinafine for fingernail onychomycosis. Br J Dermatol 133: 329, 1995.
114. NOLTING S, BRÄUTIGAM M, WEIDINGER G: Terbinafine in onychomycosis with involvement by non-dermatophytic fungi. Br J Dermatol 130: 16, 1994.
115. SEGAL R, KRITZMAN A, CIVIDALLI L, ET AL: Treatment of Candida nail infections with terbinafine. J Am Acad Dermatol 35: 958, 1996.
116. ROBERTS DT, RICHARDSON MD, DWYER PK, ET AL: Terbinafine in chronic paronychia and Candida onychomycosis. J Dermatol Treatment 3: 39, 1992.
117. TOSTI A, PIRACCINI BM, STINCHI C, ET AL: Onychomycosis due to Scopulariopsis brevicaulis: clinical features and response to systemic antifungals. Br J Dermatol 135: 799, 1996.
118. LEE KH, KIM YS, KIM MS, ET AL: Study of the efficacy and tolerability of oral terbinafine in the treatment of onychomycosis in renal transplant patients. Transplant Proc 28: 1488, 1990.
119. VELTHUIS PJ, NIJENHUIS M: Treatment of onychomycosis with terbinafine in patients with Down's syndrome. Br J Dermatol 133: 144, 1995.
120. TÖRÖK I, SIMON G, DOBOZY A, ET AL: Long-term post-treatment follow-up of onychomycosis treated with terbinafine: a multicentre trial. Mycoses 41: 63, 1998.
121. NANDWANI R, PARNELL A, YOULE M, ET AL: Use of terbinafine in HIV-positive subjects: pilot studies in onychomycosis and oral candidiasis. Br J Dermatol 134: 22, 1996.
122. HERRANZ P, GARCÍA J, DE LUCAS R, ET AL: Toenail onychomycosis in patients with acquired immune deficiency syndrome: treatment with terbinafine. Br J Dermatol 137: 577, 1997.
123. BILLSTEIN S, KIANIFARD F, JUSTICE A: Terbinafine vs. placebo for onychomycosis in black patients. Int J Dermatol 38: 377, 1999.
124. SMITH EB, STEIN LF, FIVENSON DP, ET AL: The safety of terbinafine in patients over the age of 60 years: a multicenter trial in onychomycosis of the feet. Int J Dermatol 39: 861, 2000.
125. UNGPAKORN R, REANGCHAINAM S, KULLAVANIJAYA P: Onychomycosis in a 2-year-old child successfully treated with oral terbinafine. J Am Acad Dermatol 39: 654, 1998.
126. GUPTA AK, SCHER RK, RICH P: Fluconazole for the treatment of onychomycosis: an update. Int J Dermatol 37: 815, 1998.
127. KUOKKANEN K, ALAVA S: Fluconazole in the treatment of onychomycosis caused by dermatophytes. J Dermatol Treatment 3: 115, 1992.
128. DRAKE L, BABEL D, STEWART DM, ET AL: Once-weekly fluconazole (150, 300, or 450 mg) in the treatment of distal subungual onychomycosis of the fingernail. J Am Acad Dermatol 38: S87, 1998.
129. LING MR, SWINYER LJ, JARRATT MT, ET AL: Once-weekly fluconazole (450 mg) for 4, 6, or 9 months of treatment for distal sublingual onychomycosis of the toenail. J Am Acad Dermatol 38: S95, 1998.
130. RICH P, SCHER RK, BRENEMAN D, ET AL: Pharmacokinetics of three doses of once-weekly fluconazole (150, 300, and 450 mg) in distal subungual onychomycosis of the toenail. J Am Acad Dermatol 38: S103, 1998.
131. SAVIN RC, DRAKE L, BABEL D, ET AL: Pharmacokinetics of three once-weekly dosages of fluconazole (150, 300, or 450 mg) in distal subungual onychomycosis of the fingernail. J Am Acad Dermatol 38: S110, 1998.
132. ASSAF RR, ELEWSKI BE: Intermittent fluconazole dosing in patients with onychomycosis: results of a pilot study. J Am Acad Dermatol 35: 216, 1996.
133. AIHARA Y, MORI M, YOKOTA S: Successful treatment of onychomycosis with fluconazole in two patients with hyperimmunoglobulin E syndrome. Pediatr Dermatol 13: 493, 1996.
134. SMITH SW, SEALY DP, SCHNEIDER E, ET AL: An evaluation of the safety and efficacy of fluconazole in the treatment of onychomycosis. South Med J 88: 1217, 1995.
135. COLDIRON B: Recalcitrant onychomycosis of the toenails successfully treated with fluconazole. Arch Dermatol 28: 909, 1992.
136. NAHASS GT, SISTO M: Onychomycosis: successful treatment with once-weekly fluconazole. Dermatology 186: 59, 1993.
137. HOCHMAN LG, SCHER RK, MEYERSON MS, ET AL: The safety and efficacy of oral fluconazole in the treatment of onychomycosis. J Geriatr Dermatol 1: 169, 1993.
138. DERSIMONIAN R, LAIRD NM: Meta-analysis in clinical trials. Control Clin Trials 7: 177, 1986.
139. VELANOVICH V: Meta-analysis for combining Bayesian probabilities. Med Hypotheses 35: 192, 1991.
140. VILLARS VV, JONES TC: Special features of the clinical use of oral terbinafine in the treatment of fungal diseases. Br J Dermatol 126 (suppl 39): 61, 1992.
141. DE DONCKER P, GUPTA AK, MARYNISSEN G, ET AL: Itraconazole pulse therapy for onychomycosis and dermatomycoses: an overview. J Am Acad Dermatol 37: 969, 1997.
142. ELEWSKI BE: Once-weekly fluconazole in the treatment of onychomycosis. J Am Acad Dermatol 38: S77, 1998.
143. Drug Topics Red Book: Pharmacy's Fundamental Reference, p 1, Medical Economics Co, Montvale, NJ, 2000.
144. HEALTH CARE FINANCING ADMINISTRATION: 1995 Annual Medicare Physician Fee Schedule: Carrier File, Empire New York Carrier, Baltimore, 1995.
145. HEALTH CARE FINANCING ADMINISTRATION: 1995 Clinical Diagnostic Lab Fee Schedule: Carrier File, Empire New York Carrier, Baltimore, 1995.
146. GUPTA AK, LAMBERT J: Pharmacoeconomic analysis of the new oral antifungal agents used to treat toenail onychomycosis in the USA. Int J Dermatol 38 (suppl 2): 53, 1999.
147. KATZ HI, GUPTA AK: Oral antifungal drug interactions. Dermatol Clin 15: 535, 1997.
148. GUPTA AK, KATZ HI, SHEAR NH: Drug interactions with itraconazole, fluconazole and terbinafine, and their management. J Am Acad Dermatol 41: 237, 1999.
149. GUPTA AK: Onychomycosis in the elderly. Drugs Aging 16: 397, 2000.
150. GUPTA AK, BARAN R: Ciclopirox nail lacquer solution 8% in the 21st century. J Am Acad Dermatol 43: S96, 2000.
151. AHMAD SR, SINGER SJ, LEISSA BG: Congestive heart failure associated with itraconazole. Lancet 357: 1766, 2001.