Cochrane · systematic review · CD012093
Topical and device‐based treatments for fungal infections of the toenails
Foley, K, Gupta, AK, Versteeg, S, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SkinAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
18
No studies
6
Included studies
NR
No studies 6 · 25%Ungraded 0 · 0%Very low 2 · 8.3%Low 6 · 25%Moderate 6 · 25%High 4 · 16.7%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Ciclopirox 8% lacquer compared to vehicle for fungal infections of the toenails
Population: people with fungal infections of the toenails
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure: 48 weeks Ciclopirox 8% lacquer vs vehicle | RR 9.29 [1.72, 50.14] | 2 studies · 460 participants | Low Downgraded: risk of bias, imprecision |
Adverse events (directly related to treatment, collected over the course of the studies; they are not measured/reported for specific time points) Ciclopirox 8% lacquer vs vehicle | RR 1.61 [0.89, 2.92] | 2 studies · 460 participants | Low Downgraded: risk of bias, imprecision |
Mycological cure: 48 weeks Ciclopirox 8% lacquer vs vehicle | RR 3.15 [1.93, 5.12] | 2 studies · 460 participants | Moderate Downgraded: risk of bias, imprecision |
Clinical cure ‐ not measured Ciclopirox 8% lacquer vs vehicle | no estimate extracted | NR | No studies |
Efinaconazole 10% solution compared to vehicle for fungal infections of the toenails
Population: People with fungal infections of the toenails
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure: 40 to 52 weeks Efinaconazole 10% solution vs vehicle | RR 3.54 [2.24, 5.6] | 3 studies · 1716 participants | High |
Adverse events (collected over the course of the studies; they are not measured/reported for specific time points) Efinaconazole 10% solution vs vehicle | RR 1.1 [1.01, 1.2] | 3 studies · 1701 participants | High |
Mycological cure: 40 to 52 weeks Efinaconazole 10% solution vs vehicle | RR 2.31 [1.08, 4.94] | 3 studies · 1716 participants | Moderate Downgraded: inconsistency |
Clinical cure: 40 to 52 weeks Efinaconazole 10% solution vs vehicle | RR 3.07 [2.08, 4.53] | 2 studies · 1655 participants | High |
Tavaborole 5% solution compared to vehicle for fungal infections of the toenails
Population: People with fungal infections of the toenails
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure: 52 weeks Tavaborole 5% solution vs vehicle | RR 7.4 [2.71, 20.24] | 2 studies · 1198 participants | Moderate Downgraded: imprecision |
Adverse events (directly related to treatment, collected over the course of the studies; they are not measured/reported for specific time points) Tavaborole 5% solution vs vehicle | RR 3.82 [1.65, 8.85] | 2 studies · 1186 participants | Moderate Downgraded: imprecision |
Mycological cure: 52 weeks Tavaborole 5% solution vs vehicle | RR 3.4 [2.34, 4.93] | 2 studies · 1198 participants | High |
Clinical Cure ‐ not measured Tavaborole 5% solution vs vehicle | no estimate extracted | NR | No studies |
P‐3051 (ciclopirox 8% hydrolacquer) compared to comparators for fungal infections of the toenails
Population: People with fungal infections of the toenails
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure: 48 to 52 weeks P‐3051 (ciclopirox 8% hydrolacquer) vs comparators | RR 2.43 [1.32, 4.48] | 2 studies · 490 participants | Moderate Downgraded: imprecision |
Adverse events (collected over the course of the studies; they are not measured/reported for specific time points) P‐3051 (ciclopirox 8% hydrolacquer) vs comparators | RR 0.6 [0.19, 1.92] | 2 studies · 487 participants | Low Downgraded: imprecision, inconsistency |
Mycological cure: 48 to 52 weeks P‐3051 (ciclopirox 8% hydrolacquer) vs comparators | RR 1.08 [0.85, 1.37] | 2 studies · 490 participants | Moderate Downgraded: inconsistency |
Clinical cure ‐ not measured P‐3051 (ciclopirox 8% hydrolacquer) vs comparators | no estimate extracted | NR | No studies |
1064‐nm Nd:YAG laser compared to no treatment or sham treatment for fungal infections of the toenails
Population: People with fungal infections of the toenails
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure ‐ not measured 1064‐nm Nd:YAG laser vs no treatment or sham treatment | no estimate extracted | NR | No studies |
Adverse events (collected over the course of the studies; they are not measured/reported for specific time points) 1064‐nm Nd:YAG laser vs no treatment or sham treatment | RR 4.85 [0.24, 97.11] | 2 studies · 85 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Mycological cure: 52 weeks 1064‐nm Nd:YAG laser vs no treatment or sham treatment | RR 1.04 [0.59, 1.85] | 2 studies · 85 participants | Low Downgraded: risk of bias, imprecision |
Clinical cure ‐ not measured 1064‐nm Nd:YAG laser vs no treatment or sham treatment | no estimate extracted | NR | No studies |
Luliconazole 5% solution compared to vehicle for fungal infections of the toenails
Population: People with fungal infections of the toenails
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure: 48 weeks Luliconazole 5% solution vs vehicle | RR 2.96 [1.18, 7.41] | 1 study · 293 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events (collected over the course of the studies; they are not measured/reported for specific time points) Luliconazole 5% solution vs vehicle | RR 1.02 [0.9, 1.16] | 1 study · 293 participants | Low Downgraded: risk of bias, imprecision |
Mycological cure: 48 weeks Luliconazole 5% solution vs vehicle | RR 1.39 [0.98, 1.97] | 1 study · 293 participants | Low Downgraded: risk of bias, imprecision |
Clinical Cure ‐ not measured Luliconazole 5% solution vs vehicle | no estimate extracted | NR | No studies |