nnd-502 and tavaborole

Fungal diseases of the nail bed (onychomycosis) and epidermis are recurrent illnesses in the elderly and immunocompromised patients, which have few efficacious treatment options. Current treatment options for onychomycosis are limited to topical agents, laser treatment, and oral antifungals. Previous generations of topical agents were not efficacious, owing to poor penetration of the nail bed. Oral antifungal drugs, such as itraconazole, terbinafine, and fluconazole, not only give better response rates but also inhibit a host of CYP450 enzymes. Oral antifungals can exacerbate drug-drug interactions for patients taking other medications concurrently. Newer topical agents might recognize improved efficacy and provide therapeutic alternatives when the use of oral antifungal agents is contraindicated. Recently, the Food and Drug Administration (FDA) approved efinaconazole and tavaborole for the treatment of onychomycosis. Additionally, the FDA approved luliconazole for the treatment of tinea pedis, tinea cruris, and tinea corporis. This review examines the mechanism of action, spectrum of activity, pharmacokinetics, and clinical trials data and considers the place in therapy for these 3 new antimycotic agents.

Topics: Administration, Topical; Animals; Antifungal Agents; Arthrodermataceae; Boron Compounds; Bridged Bicyclo Compounds, Heterocyclic; Dermatomycoses; Humans; Imidazoles; Microbial Sensitivity Tests; Randomized Controlled Trials as Topic; Treatment Outcome; Triazoles

Topics: Acids, Carbocyclic; Benzoxazines; Boron Compounds; Bridged Bicyclo Compounds, Heterocyclic; Cephalosporins; Cyclopentanes; Drug Approval; Drug Combinations; Drug Therapy; Glucagon-Like Peptides; Guanidines; Humans; Imidazoles; Immunoglobulin Fc Fragments; Interferon-beta; Isoquinolines; Penicillanic Acid; Polyethylene Glycols; Pyridines; Quinuclidines; Recombinant Fusion Proteins; Tazobactam; Triazoles; United States; United States Food and Drug Administration

Approximately 20-25% of the population worldwide is affected by superficial cutaneous mycoses (SCM). SCM are cutaneous fungal infections with a wide array of systemic and topical treatment options. However, successful therapeutic outcomes are limited by patient non-adherence, medication side effects, potential drug interactions, antifungal resistance and disease recurrence. Advances in formulation technology have allowed for the development of more effective and safer therapies. In this article we will review several new and emerging pharmacotherapeutics for onychomycosis and tinea pedis.

Topics: Allylamine; Antifungal Agents; Boron Compounds; Bridged Bicyclo Compounds, Heterocyclic; Education, Medical, Continuing; Humans; Imidazoles; Itraconazole; Onychomycosis; Tinea Pedis; Triazoles