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01-06-2020 | CO2 Laser | Original Research Article

Comparative Study of Traditional Ablative CO₂ Laser-Assisted Topical Antifungal with only Topical Antifungal for Treating Onychomycosis: A Multicenter Study

Authors: Bhavana Rajbanshi, Liangliang Shen, Miao Jiang, Qingyu Gao, Xin Huang, Jiaoyang Ma, Jihong Wang, Yang Hu, Hongli Lv, Xiao Wu, Jingjun Zhao

Published in: Clinical Drug Investigation | Issue 6/2020

Abstract

Background

The predominance of onychomycosis has been increasing recently. New medications and treatment modalities are being researched for better saturation of the antifungal agents through the nail plate topically because of the low resilience of some patients for the oral antifungal agents. Treatment of onychomycosis, mainly moderate to severe, can be very challenging, expensive, and time consuming.

Objective

The objective of this clinical trial is to compare the efficacy and safety of a manually operated ablative CO₂ laser combined with a topical antifungal agent in patients with onychomycosis.

Study Design

We conducted an open-label controlled prospective study of 160 eligible patients randomized into control and treatment groups with a 1:1 allocation in the department of dermatology in five different hospitals in Shanghai. It was a 6-month study where both groups were treated with a topical antifungal agent, with the treatment group also receiving ablation by the traditional CO₂ laser once a month for the first 3 months.

Results

The clinical efficacy and mycological cure rate were significantly higher (p < 0.001) for the treatment group. Three (3.75%) patients from the control group and 18 (25%) patients from the treatment group achieved complete nail clearance along with negative potassium hydroxide and negative culture (primary endpoint) results at 24 weeks. Mycological clearance with at least moderate nail clearance (secondary endpoint) for the treatment group was also significantly higher (p < 0.001) for the laser treatment group. The laser treatment was mildly painful but tolerable by the patients. No drug interactions for both groups were encountered.

Conclusions

The ablative CO₂ laser is a primitive yet effective modality to be considered for the delivery of topical antifungal agents for the management of mild-to-severe onychomycosis. The laser has good tolerance in patients and is a common equipment found in most dermatology units even those without the latest medical technology.

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Title: Comparative Study of Traditional Ablative CO2 Laser-Assisted Topical Antifungal with only Topical Antifungal for Treating Onychomycosis: A Multicenter Study
Authors: Bhavana Rajbanshi
Liangliang Shen
Miao Jiang
Qingyu Gao
Xin Huang
Jiaoyang Ma
Jihong Wang
Yang Hu
Hongli Lv
Xiao Wu
Jingjun Zhao
Publication date: 01-06-2020
Publisher: Springer International Publishing
Keywords: CO2 Laser
Onychomycosis
Laser
Published in: Clinical Drug Investigation / Issue 6/2020
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI: https://doi.org/10.1007/s40261-020-00914-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparative Study of Traditional Ablative CO₂ Laser-Assisted Topical Antifungal with only Topical Antifungal for Treating Onychomycosis: A Multicenter Study

Abstract

Background

Objective

Study Design

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Study Design

Results

Conclusions

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