Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new penlac research articles will be listed here shortly after becoming available to us.
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Medical research on penlac
Mycoses. 2008 May 21;
Ghannoum MA, Long L, Pfister WR
Currently available topical antifungals are often not satisfactory for the treatment of nail infections, because of the inability to penetrate the nail plate. Terbinafine HCl nail solution is a novel antifungal formulation containing a nail penetration enhancer dodecyl-2-N,N-dimethylaminopropionate hydrochloride (DDAIP HCl, trade name NexACT((R))-88). In this study, we used a guinea pig model of Trichophyton mentagrophytes dermatophytosis and evaluated the clinical and mycological efficacy of different terbinafine HCl nail solutions (TNS) formulated with or without DDAIP HCl. Ciclopirox (8%) nail lacquer (Penlac((R))), the only Food and Drug Administration approved topical treatment for onychomycosis, was used as a comparator. Following the IACUC Guidelines, the skin of male albino guinea pigs was abraded under anaesthesia. Each animal was infected with T. mentagrophytes ATCC 24953 (cell suspension containing 1 x 10(7) conidia). The experimental animals were divided into 11 groups (five animals per group) and tested with the following formulations: vehicle control, 0.5% DDAIP HCl, 1%, 5% and 10% TNS (without DDAIP HCl), 1% TNS with 0.5%, 2.5% and 5.0% DDAIP HCl, 5% and 10% TNS with 0.5% DDAIP HCl, 8% ciclopirox nail lacquer and an untreated control group. Evaluation of clinical and mycological efficacy was performed 72 h after completion of a 7-day treatment regimen. Skin biopsy samples were processed for histopathological examination. The infected untreated control guinea pigs showed patches of hair loss and ulcerated or scaly skin and fungal invasion of hair roots. The vehicle and 0.5% DDAIP HCl treated groups showed minimal clinical efficacy (only 11% and 5%, respectively). In contrast, all three concentrations of TNS (1%, 5% and 10% terbinafine HCl) formulated with or without 0.5% DDAIP HCl showed 100% mycological efficacy by the hair root invasion test. Clinical efficacy of the 5% and 10% TNS improved with addition of 0.5% DDAIP HCl (47.4% and 73.8% vs. 68.4% and 89.5%, respectively). In addition, no fungal elements were detected in the treated guinea pig skin. All formulations of TNS resulted in a higher clinical and mycological efficacy compared with the 8% ciclopirox nail lacquer (P = 0.0444). In conclusion, TNS containing 1%, 5% and 10% terbinafine HCl formulated with and without DDAIP HCl demonstrated high antifungal efficacy in experimental dermatophytosis. Addition of 0.5% DDAIP HCl to 5% and 10% TNS significantly enhanced the clinical and mycological efficacy of these formulations which were superior compared with the 8% ciclopirox nail lacquer. Evaluation of the 1%, 5% and 10% TNS in clinical trials for the treatment of dermatophytosis and onychomycosis is warranted.
Review of antifungal therapy and the severity index for assessing onychomycosis: part I.
J Dermatolog Treat. 2008; 19(2): 72-81
Baran R, Hay RJ, Garduno JI
This review outlines recent data on treatment modalities and outcomes with antifungal therapy in onychomycosis. Included are topical, mechanical, chemical and systemic treatments or a combination thereof. Topical treatments, or transungual drug delivery systems (TUDDS), including ciclopirox and amorolfine were shown to be effective if used alone for mild-moderate nail involvement. Specifically, superficial white onychomycosis (SWO) restricted to the dorsum of the nail plate and moderate distal lateral subungual onychomycosis (DLSO). Mechanical treatments were mostly effective as adjuncts to topical therapy which include nail avulsion and abrasion. In particular, partial nail avulsion aids topical therapy in DLSO and partial subungual onychomycosis for a more effective therapy. Chemical avulsion is a painless method of debridement which uses a keratinolysis formula that is effective only in limited and early disease. Systemic therapies have been shown to be effective with terbinafine and itraconazole is suggested as being the most cost-effective therapy. Systemic therapies require consideration of side effects and monitoring by both patient and physician prior to treatment application. An effective suggestion is the use of a topical with debridement for mild-moderate onychomycosis and systemic (terbinafine) plus topical for severe onychomycosis. Most treatment modalities will require long-term use from 3 to 9 months to be most effective, with strategies presented in Part II of this review.
Update in Antifungal Therapy of Dermatophytosis.
Mycopathologia. 2008 May 14;
Gupta AK, Cooper EA
Treatment of dermatophyte infection involves primarily oral and/or topical formulations of azoles or allylamines, particularly itraconazole and terbinafine. Topical medications applied once or twice daily are the primary treatment indicated for tinea corporis/cruris, and tinea pedis/manuum. Use of oral antifungals may be practical where the tinea involvement is extensive or chronic, or where application of a topical is not feasible. For tinea unguium (onychomycosis) and tinea capitis, oral therapies are the primary treatments provided. Recently, topical amorolfine and ciclopirox formulations have been approved for use in milder onychomycosis cases, and their role in the treatment of the different clinical forms of onychomycosis is currently being defined. Relapse of infection remains a problem, particularly with tinea pedis/unguium. Appropriate follow-up duration and education of patients on proper foot hygiene are also important components in providing effective therapy.
J Pharm Biomed Anal. 2008 Aug 5; 47(4-5): 929-33
Li J, Jiang Y, Sun T, Ren S
A rapid, simple and specific method has been developed and validated for the assay of ciclopirox olamine in pharmaceutical formulations using micellar electrokinetic capillary chromatography (MEKC). The key factors, including pH, buffer concentration and buffer additive, sodium dodecyl sulfate (SDS) concentration, applied voltage and injection time have been systematically investigated in a fused silica capillary (i.d. 50mum, total length 45cm and effective length 38cm) with UV detection at 298nm. Optimized conditions have been established on the basis of the experimental results. The buffer contains 200mM borate, 20mM SDS and 2mgmL(-1) EDTA at pH 8.0 and the applied voltage is 20kV with hydrodynamics sample injection (15cm high for 5s). The method has been validated with respect to its specificity, linearity, limits of detection, and quantification, precision and accuracy. The total analysis time was less than 10min with good peak shape for ciclopirox olamine, which eluted at 3.6min. Degradation of the ciclopirox olamine was forced using different conditions. These were using hydrogen peroxide, acidic and basic conditions, heat and light. The degradation products so produced showed no interference with ciclopirox olamine. A linear standard curve was established over the concentration range 31.3-2.00x10(3)mugmL(-1) of ciclopirox olamine in running buffer with a correlation coefficient (r) of 0.9999. The limits of quantification and detection were 31.3 and 9.36mugmL(-1), respectively. The proposed method has been successfully used for the quantitative determination of ciclopirox olamine in pharmaceutical suppository and cream formulations.
Drug treatments for skin disease introduced in 2007.
Skin Therapy Lett. 2008 Mar; 13(2): 7-9
A comprehensive list of drug treatments for skin disease including: Adapalene Gel 0.3% (Differin(R)), Drospirenone/ Ethinyl Estradiol (Yaz(R)), Tretinoin 0.05% Gel (Anthralin(R)), Daptomycin for Injection (CUBICIN(R)), Retapamulin Ointment 1% (Altabax(R)), Tinidazole Tablets (Tindamax(R)), Ciclopirox Topical Solution 8%, Ketoconazole 2% Foam (Extina(R)), Terbinafine Hydrochloride (Lamisil(R)), Desloratadine (Aerius(R)/ Azomyr(R)/ Neoclarityn(R)), Levocetirizine Dihydrochloride (Xyzal(R)), Loratadine Dry Syrup 1% (Claritin(R)) and many other treatments introduced in 2007.
Ciclopirox olamine directly scavenges hydroxyl radical.
Int J Dermatol. 2008 Jan; 47(1): 15-8
Sato E, Kohno M, Nakashima T, Niwano Y
[Mucoadhesive tablets for oral administration of ciclopiroxolamine]
Ceska Slov Farm. 2007 Oct; 56(5): 243-8
Kuna M, Rabisková M
Oral mucoadhesive tablets belong to modern dosage forms, which allow controlled drug release after buccal application. They are used for the treatment of oral cavity disorders or for systemic administration of drugs with high first-pass effect or drugs instable in gastrointestinal tract. This study reports the development of oral mucoadhesive tablets containing antimycotic drug ciclopiroxolamine. Mucoadhesive properties of placebo tablets containing different ratios of carbomer and hydroxypropylmethylcellulose were evaluated in vivo in healthy human volunteers. The longest mucoadhesion for 9 hours was achieved in matrices containing 60% (w/w) of carbomer. When optimum combination of the two mucoadhesive polymers was selected, tablets containing ciclopiroxolamine were prepared and one tablet side was film-coated to make the application procedure easier. Tablet quality parameters were determined and drug dissolution profile was evaluated under different pH conditions. In vitro release of ciclopiroxolamine was slower than the desintegration of prepared mucoadhesive tablets in vivo. Nevertheless, tablets containing 25 mg of ciclopiroxolamine performed prolonged drug release with oral mucosa concentrations higher than its MIC of relevant pathogens.
Malassezia furfur onychomycosis in an immunosuppressed liver transplant recipient.
Indian J Dermatol Venereol Leprol. 2007 Nov-Dec; 73(6): 425-6
Ertam I, Aytimur D, Alper S
Indian J Dermatol Venereol Leprol. 2007 Nov-Dec; 73(6): 393-6
Jaiswal A, Sharma RP, Garg AP
BACKGROUND: Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts and molds. AIMS: To study the efficacy and safety of oral terbinafine pulse as a monotherapy and in combination with topical ciclopirox olamine 8% or topical amorolfine hydrochloride 5% in onychomycosis. METHODS: A clinical comparative study was undertaken on 96 Patients of onychomycosis during the period between August 2005 to July 2006. Forty-eight patients were randomly assigned in group A to receive oral terbinafine 250 mg, one tablet twice daily for seven days every month (pulse therapy); 24 patients in group B to receive oral terbinafine pulse therapy plus topical ciclopirox olamine 8% to be applied once daily at night on all affected nails; and 24 patients in group C to receive oral terbinafine pulse therapy plus topical amorolfine hydrochloride 5% to be applied once weekly at night on all the affected nails. The treatment was continued for four months. The patients were evaluated at four weekly intervals till sixteen weeks and then at 24 and 36 weeks. RESULTS: We observed clinical cure in 71.73, 82.60 and 73.91% patients in groups A, B and C, respectively; Mycological cure rates against dematophytes were 88.9, 88.9 and 85.7 in groups A, B and C, respectively. The yeast mycological cure rates were 66.7, 100 and 50 in groups A, B and C, respectively. In the case of nondermatophytes, the overall response was poor: one out of two cases (50%) responded in group A, while one case each in group B and group C did not respond at all. CONCLUSION: Terbinafine pulse therapy is effective and safe alternative in treatment of onychomycosis due to dermatophytes; and combination therapy with topical ciclopirox or amorolfine do not show any significant difference in efficacy in comparison to monotherapy with oral terbinafine.
A case report of Hailey-Hailey disease treated with alefacept (Amevive).
Br J Dermatol. 2008 Feb; 158(2): 399-401
Hurd DS, Johnston C, Bevins A
Hailey-Hailey disease (chronic benign familial pemphigus) is a chronic, recurrent blistering disorder characterized clinically by erosions occurring primarily in intertriginous regions and histologically by suprabasilar acantholysis. We report a case of Hailey-Hailey disease initially unresponsive to multiple topical corticosteroids, tetracycline, dapsone, ciclosporin, isotretinoin, prednisone, methotrexate, topical ciclopirox, tazarotene cream, pimecrolimus cream and tacrolimus ointment. Partial response of this patient's perineal disease was achieved with Amevive 15 mg weekly for 12 weeks, intramuscularly. To our knowledge, this case represents the first such published report of successful treatment of Hailey-Hailey disease using alefacept.