序贯疗法治疗甲真菌病的临床研究

目的:探讨不同治疗方案对甲真菌病的作用及不良反应。方法:对125例甲真菌病患者分别采用伊曲康唑和特比萘芬序贯疗法、伊曲康唑冲击治疗和特比萘芬连续治疗,对其临床效果及不良反应进行评价。结果:三组具有相似的临床疗效,但序贯疗法更安全、经济。结论:序贯疗法是治疗甲真菌病的最佳治疗方案。     

3种抗真菌药治疗甲真菌病药物经济学分析

目的对伊曲康唑、特比萘芬、氟康唑3种不同抗真菌药物治疗120例甲真菌病患者的成本效果分析。方法选择120例病例,随机分为3组,分别给予伊曲康唑、特比萘芬、氟康唑治疗,观察各组疗效并运用药物经济学方法进行分析。结果3种药物均有较好的抗真菌疗效,特比萘芬疗效优于伊曲康唑及氟康唑,伊曲康唑疗效优于氟康唑。平均成本-效果比分别为8.9,8.0,11.7。结论药物经济学分析结果为特比萘芬治疗甲真菌病最优。     

两种方案治疗甲真菌病的成本-效果分析

目的:探讨比较伊曲康唑胶囊与特比萘芬片治疗甲真菌病的成本-效果.方法:将临床甲真菌病患者分为A、B两组,A组82例采用伊曲康唑胶囊口服治疗,B组79例采用特比萘芬片口服治疗,应用药物经济学成本-效果分析法进行评价.结果:伊曲康唑胶囊与特比萘芬片治疗指/趾甲真菌病的总有效率分别为89.02%(73/82)和91.14%(72/79);成本分别为1039.92元和1 659.6元;C/E分别为11.68、18.21;△C/△E为292.3.结论:伊曲康唑胶囊具有更合理成本-效果优势.     

3种抗真菌药物治疗甲真菌病的成本-效果分析

目的探讨3种抗真菌药物治疗甲真菌病的经济成本。方法选择100例患者随机分为3组,分别给予氟康唑、特比萘芬、伊曲康唑治疗,运用药物经济学的成本-效果分析方法进行评价。结果治疗指甲真菌病所需药品成本分别是,氟康唑92．80元、特比萘芬474．88元、伊曲康唑564．48元;治疗趾甲癣真菌病所需药品成本分别是,氟康唑139．20元、特比萘芬682．64元、伊曲康唑846．72元。3种药物治疗甲真菌病的痊愈率分别是72．73％,78．12％,80．00％。结论国产氟康哇是治疗甲真菌病的较佳药物。     

特比萘芬治疗真菌病现状

特比萘芬是一种丙烯胺类的抗真菌药物 ,具有广谱抗真菌活性 ,临床上有口服和外用制剂。广泛用于治疗浅部真菌病 ,结果显示特比萘芬治疗浅部真菌病疗程短、疗效高、不良反应少、复发率低。尤其对甲真菌病进行短程连续疗法、冲击疗法、短程隔日疗法比较 ,以短程连续疗法疗效最好。对由皮肤癣菌引起的甲真菌病特比萘芬比灰黄霉素、伊曲康唑和氟康唑疗效要好。除此之外 ,特比萘芬还有效治疗了一些曲霉病、孢子丝菌病和着色芽生菌病。     

伊曲康唑与特比萘芬治疗甲真菌病的研究

目的比较伊曲康唑与特比萘芬治疗甲真菌病的临床疗效。方法取220例甲真菌病患者,随机分为2组,一组给予特比萘芬0.25g,qd,指甲真菌病组连服6周,趾甲真菌病或指甲真菌病合并趾甲真菌病组连服12周。另一组给予伊曲康唑0.2g,bid,连服1周,停药3周为1个冲击疗程,指甲真菌病组连服2个冲击疗程,趾甲真菌病或指甲真菌病合并趾甲真菌病组连服3个冲击疗程。结果指甲真菌病痊愈率和愈显率特比萘芬组为87.0%和95.7%,伊曲康唑组为73.9%和78.3%。趾甲真菌病或指甲真菌病合并趾甲真菌病痊愈率和愈显率特比萘芬组为87.5%和95.3%,伊曲康唑组为75.0%和82.8%。结论特比萘芬治疗甲真菌病疗效优于伊曲康唑(P<0.05)。     

3种抗真菌药治疗甲真菌病的成本-效果比较

目的探讨不同抗真菌药治疗甲真菌病的经济效果.方法选择120例甲真菌病患者,随机分成A、B、C3组,分别给予伊曲康唑、特比萘芬、氟康唑口服治疗,运用药物经济学的成本-效果分析方法进行评价.结果 A、B、C 3组方案中治疗指甲真菌病/趾甲真菌病的成本-效果比分别为10.23/15.07,9.21/12.56,10.61/15.99;敏感度分析后分别为9.17/13.32、8.27/11.14、9.58/14.24.结论 B组方案为治疗甲真菌病的最经济有效方案.     

伊曲康唑和特比萘芬治疗甲癣的优劣

伊曲康唑和特比萘芬有较好的药低学特性，特别是通过口服给药随血运达甲床，进而渗透进入甲板，起抑杀真效果，它们在甲内药代学特性表明有后效应，病人耐受良好，伊曲康唑可治疗甲真菌病，而特比萘芬治疗甲癣。     

3种抗真菌药物治疗手甲癣的费用-效果分析

目的探讨不同药物治疗方案对同一疾病所产生的经济效果.方法以文献为依据,对120例手甲癣患者随机分3组,分别使用伊曲康唑、特比萘芬和酮康唑治疗,运用药物经济学原理进行费用-效果分析评价.结果伊曲康唑组为治疗手甲癣的最佳治疗方案.结论药物经济学在优化治疗方案,确定最佳治疗药物,以用最少费用获得最大效益方面具有指导作用.     

特比萘芬与伊曲康唑治疗甲真菌病的比较研究

目的：研究特比萘芬与伊曲康唑治疗甲真菌病的疗效及不良反应。方法：将本院2007年12月～2008年10月收治46例甲真菌病患者随机分为观察组（23例）及对照组（23例）。观察组采用特比萘芬治疗,而对照组采用伊曲康唑治疗,比较分析两组患者的疗效及不良反应。结果：两组患者的近期有效率、近期治愈率及远期治愈率比较,差异均无统计学意义,P〉0.05;两组患者不良反应发生率相比,差异亦无统计学意义,P〉0.05。结论：特比萘芬与伊曲康唑治疗甲真菌病均疗效满意,安全性高,临床上应选择两者中更为经济的药物推广使用。     

三种治疗甲真菌病药物的成本——效果分析

目的：探讨3种抗真菌药（伊曲康唑、特比奈芬、氟康唑）治疗甲真菌病的经济效果,找出既经济又有效的治疗方案。方法：根据文献选择3种不同的治疗方案（伊曲康唑组、特比奈芬组、氟康唑组）,应用药物经济学成本-效果分析法。结果：治疗指甲真菌病所需药品成本分别是666.68,634.42,459.96元;治疗趾甲真菌病所需的药品成本分别是1000.02,911.98,689.94元。远期治愈率指甲真菌病分别是94.4%,100.0%和77.8%;趾甲真菌病分别是86.4%,95.2%和68.2%。结论：根据药物经济学成本-效果分析,特比奈芬是治疗甲真菌病的最佳药物。     

特比萘芬联合10%浓碘酊治疗甲真菌病疗效观察

目的观察特比萘芬联合10%浓碘酊外用治疗甲真菌病的疗效及安全性。方法将112例甲真菌病患者随机分为2组,治疗组60例给予特比萘芬片250mg口服,每天1次,连服7d后,改为隔日服用1次,指甲真菌感染患者连用7周,趾甲真菌感染患者连用9周;同时加用10%浓碘酊外涂,每天2次,指(趾)甲真菌感染患者连用时间分别为8周和10周。对照组52例给予特比萘芬片250mg口服,每天1次,指甲真菌感染患者连服8周,趾甲真菌感染患者连服10周。结果治疗组停药时、停药后6个月总有效率比较差异无统计学意义(P>0.05)。治疗组不良反应发生率为3.3%低于对照组的17.3%,差异均有统计学意义(P<0.05)。在疗效相当的情况下,治疗组所需药品费用低于对照组(P<0.05)。结论特比萘芬联合10%浓碘酊外用治疗甲真菌病临床疗效好,不良反应少,安全有效,节省治疗费用,值得临床推广应用。     

特比萘芬与伊曲康唑治疗甲真菌病比较

目的 :比较特比萘芬片剂和伊曲康唑胶囊治疗甲真菌病的有效性和安全性。方法 :甲真菌病病人 76例随机分成 2组。特比萘芬组 38例 (男性14例 ,女性 2 4例 ,年龄 4 6a±s 14a ,病甲 338个 ) ,用特比萘芬wk 1,2 50mg ,po ,qd ,wk 2～ 7或 12 ,2 50mg ,po ,qod ;伊曲康唑组 38例 (男性 17例 ,女性 2 1例 ,年龄 4 5a± 13a ,病甲 2 52个 ) ,用伊曲康唑2 0 0mg ,po ,bid ,连用 1wk ,停药 3wk为一个疗程 ,2～ 3个疗程。结果 :特比萘芬和伊曲康唑治疗甲真菌病 ,近期疗效总痊愈率分别为 10 %和 10 % ,总有效率分别为 2 6 %和 34% ,真菌学总痊愈率分别为6 3%和 6 6 % ;远期疗效总痊愈率分别为 76 %和82 % ,总有效率分别为 90 %和 87% ,真菌学总痊愈率分别为 92 %和 90 %。不良反应发生率分别为8%和 5%。 2组的临床疗效和安全性比较 ,差异无显著意义 (P >0 .0 5)。结论 :国产特比萘芬治疗甲真菌病疗效好 ,安全性高 ,与伊曲康唑比较疗效相似。     

Cost effectiveness of oral terbinafine (Lamisil) compared with oral fluconazole (Diflucan) in the treatment of patients with toenail onychomycosis

OBJECTIVE: To determine the cost effectiveness of terbinafine (Lamisil) tablets compared with fluconazole (Diflucan) capsules in the treatment of patients with toenail onychomycosis. METHODS: Data from a randomised, double-blind, double-dummy, multicentre study were used as the basis for this study. Terbinafine 250 mg/day for 12 weeks (n = 48) was compared with fluconazole 150mg once weekly for 12 weeks (n = 45) or 24 weeks (n = 44) in patients with culture-confirmed toenail onychomycosis caused by dermatophyte infection. At the end of the study (week 60), complete clinical cure of the target toenail was achieved in 67% of patients in the terbinafine group, compared with 21 and 32%, respectively, in the 12- and 24-week fluconazole groups. We subsequently used these data to calculate the cost effectiveness of the three treatment regimens, defining cost effectiveness as the cost per complete clinical cure of the target toenail at week 60. RESULTS: The cost effectiveness of terbinafine for each complete clinical cure was superior to that of either of the fluconazole regimens. Costs per cure were Finnish markka (Fmk) 2824 ($US618) for terbinafine, compared with Fmk3748 ($US820) and Fmk4922 ($US1077), respectively, for the two fluconazole regimens. CONCLUSIONS: The clinical study showed that terbinafine was significantly more effective than fluconazole in the treatment of onychomycosis, achieving statistically higher rates of mycological and clinical cure. We have now shown that terbinafine is also more cost effective. These findings have important implications for both medical and social policy.     

Therapeutic potential of TDT 067 (terbinafine in Transfersome®): a carrier-based dosage form of terbinafine for onychomycosis

Introduction: Current topical treatments for onychomycosis are unsatisfactory. New topical agents that offer efficacy without the potential adverse effects of oral antifungal therapy would benefit patients with this condition and encourage a greater treatment rate. Areas covered: Currently available topical therapies are reviewed, and new approaches for enhancing delivery of the established antifungal terbinafine through the nail are summarized. We focus on the use of ultra-deformable lipid vesicles to facilitate delivery of terbinafine to the nail and surrounding tissue. TDT 067 (terbinafine in Transfersome?) is the only such therapy in development for onychomycosis, and we review published preclinical and clinical studies on this formulation. Expert opinion: TDT 067 offers the use of new technology to deliver an established antifungal, terbinafine. Preclinical data suggest that the Transfersome? accelerates entry of terbinafine released from TDT 067 into fungi and potentiates its antifungal effects, resulting in enhanced activity, compared with conventional terbinafine. This translated into high rates of mycological cure and evidence of clinical effect in a study of TDT 067 administered twice daily for 12 weeks in patients with onychomycosis. An ongoing Phase-III trial involving more than 700 patients treated for 48 weeks is investigating the efficacy and safety of TDT 067.     

伊曲康唑不同治疗方案对比特比萘芬治疗甲真菌病疗效和安全性的Meta分析

目的:系统评价伊曲康唑不同治疗方案对比特比萘芬治疗甲真菌病的临床疗效与安全性,以为临床治疗提供循证参考。方法:计算机检索Pub Med、EMBase、Medline、The Cochrane Library、中国期刊全文数据库、维普中文科技期刊全文数据库、万方数字化期刊全文库,收集伊曲康唑对比特比萘芬治疗甲真菌病的随机对照试验(RCT),提取资料并评价质量后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入11项RCT,合计1 886例患者。Meta分析结果显示,伊曲康唑连续治疗的临床治愈率[RR=0.94,95%CI(0.76,1.18),P=0.61]与特比萘芬比较差异无统计学意义,而真菌学治愈率[RR=0.80,95%CI(0.68,0.95),P=0.01]和总治愈率低于特比萘芬,两组比较差异有统计学意义;伊曲康唑冲击治疗的临床治愈率[RR=0.75,95%CI(0.65,0.87),P<0.000]和总治愈率[OR=0.39,95%CI(0.27,0.55),P<0.000]低于特比萘芬,而真菌学治愈率与特比萘芬比较差异无统计学意义[RR=0.82,95%CI(0.63,1.07),P=0.14];两组患者消化系统不良反应发生率比较,差异无统计学意义[OR=1.02,95%CI(0.83,1.25),P=0.86]。结论:伊曲康唑不同治疗方案治疗甲真菌病的疗效均低于特比萘芬,安全性相似。由于纳入研究数量较少、质量一般,该结论尚有待大样本、高质量的RCT进一步验证。     

Terbinafine. A pharmacoeconomic evaluation of its use in superficial fungal infections

Terbinafine is an orally and topically active allylamine antifungal drug which is an effective and well tolerated therapy for a wide range of superficial dermatophyte infections. In contrast to most other commonly prescribed antifungal agents, terbinafine is fungicidal in vitro and possesses improved pharmacokinetic properties with respect to drug penetration into nail tissue following oral administration. These properties enable terbinafine to achieve high success rates with shortened therapy regimens in the treatment of dermatophyte skin infections and onychomycosis. Pharmacoeconomic analyses have shown that oral terbinafine, with its higher rates of clinical efficacy and lower rates of relapse/reinfection, is less costly and more cost effective than oral griseofulvin, ketoconazole and itraconazole when used as initial therapy in the treatment of onychomycosis. However, some points regarding the clinical efficacy of itraconazole relative to terbinafine and the drug treatment regimens used in these studies need further clarification. In the management of tinea pedis, a cost analysis suggested that initial therapy with terbinafine 1% cream was more costly than initial therapy with miconazole, oxiconazole or clotrimazole. However, in cost-effectiveness studies, terbinafine had a lower cost per disease-free day than ciclopirox, clotrimazole, ketoconazole and miconazole in the treatment of dermatophyte skin infections. In conclusion, available clinical and pharmacoeconomic data support the use of topical terbinafine as first-line treatment of dermatophyte skin infections unless the acquisition cost of terbinafine is markedly greater than that of alternative topical antifungal agents. Oral terbinafine can be recommended as a cost-effective first-line treatment, preferable to oral griseofulvin, ketoconazole and itraconazole, in patients with dermatophyte onychomycosis.     

特比萘芬和氟康唑治疗复发性阴道念珠菌病

目的：观察特比萘芬和氟康唑联合治疗复发性外阴阴道念珠菌病（RVVC）的临床效果。方法：94例RVVC患者随机分为特比萘芬组30例，予特比萘芬片0．25g，po qd；氟康唑组31例，予氟康唑胶囊0．15g，po qd；联合组33例：予特比萘芬片和氟康唑胶囊，用法、剂量同前两组。三组疗程均7d。每组病例停药后2周、6个月、12个月统计疗效。结果：联合组的临床痊愈率、有效率和真菌清除率不论在治疗后2周、6个月、12个月，均高于另两组，统计学差异显著。结论：特比萘芬和氟康唑联合应用治疗RVVC的疗效优于单一使用特比萘芬或氟康唑。