Treatment Outcome with Fosravuconazole for Onychomycosis
Treatment Outcome with Fosravuconazole for Onychomycosis
复制标题
福斯拉康唑治疗甲癣的治疗结果
DOI：
10.1007/s11046-021-00540-6
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发表时间：
2021
期刊：
影响因子：
5.5
通讯作者：
Y. Kuwano
中科院分区：
文献类型：
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作者：
Harunari Shimoyama;Ayaka Yo;Y. Sei;Y. Kuwano
甲氧氟康唑L赖氨酸乙醇酯(F-RVCZ)是雷武康唑类前药，是一种治疗甲真菌病的新药。然而，关于F-RVCZ疗效的临床数据有限，因为该药物仅于2018年在日本推出。因此，我们分析了F-RVCZ疗法在日本皮肤科门诊治疗甲真菌病的结果。我们检查了109名不同临床类型的患者(男性68名，女性41名)的数据，包括完全营养不良甲真菌病和皮肤真菌病，以及包括老年人在内的广泛年龄组。12周完全治愈率为6.4%(7/10 9)，最后一次治愈率为6 7.9%(74/10 9)，平均为32 ± 14.2周。术后12周患甲平均改善率为49.1 ± 23.3%，上次就诊时为86.8 ± 22.4%。术后12周和最后一次随访疗效分别为：无效4例和1例；轻度35例和4例；中度51例和21例；显效12例和9例；完全治愈7例和74例。没有发生严重的不良反应。这项回溯性调查是对实际临床实践结果的第一次大规模分析，排除的可能性很小。与以前的报告相比，我们的结果显示F-RVCZ治疗在各种患者中具有良好的疗效。考虑到我们的结果和口服给药的简便性(每天1粒，连续12周)和很少的不良反应，F-RVCZ疗法似乎是治疗甲真菌病的有用选择。
Fosravuconazole L-lysine ethanolate (F-RVCZ), a ravuconazole prodrug, is a newly available agent with high expectations for efficacy in the treatment of onychomycosis. However, clinical data regarding the efficacy of F-RVCZ are limited because the drug was launched only in Japan in 2018. Therefore, we analyzed the outcome of F-RVCZ therapy in the treatment of onychomycosis at outpatient dermatology clinics in Japan. We examined data for 109 patients (68 male, 41 female) with varying clinical type, including total dystrophic onychomycosis and dermatophytoma, and a wide range of age groups, including the elderly. The complete cure rate at 12 weeks was 6.4% (7/109) and 67.9% (74/109) at the last visit (mean time to last visit: 32 ± 14.2 weeks). Mean rate of improvement in the affected nail area was 49.1 ± 23.3% at 12 weeks and 86.8 ± 22.4% at the last visit. Efficacy at 12 weeks and the last visit, respectively, was as follows: none, 4 cases and 1 case; slight, 35 cases and 4 cases; moderate, 51 cases and 21 cases; significant, 12 cases and 9 cases; complete cure, 7 cases and 74 cases. There were no serious adverse events. This retrospective survey was the first large-scale analysis of actual clinical practice outcomes and had minimal exclusions. Compared to previous reports, our results demonstrated excellent efficacy of F-RVCZ therapy in a variety of patients. Considering our results and the ease of oral administration (1 capsule/day for 12 weeks) and few adverse events, F-RVCZ therapy appears to be a useful option for the treatment of onychomycosis.