mallefet_edit1.qxp 28/5/09 2:11 pm Page 22
Tinea Pedis
Figure 1: Meta-analyses of Mycological Cure Rate with Each Antifungal Compared with Vehicle
Meta-analysis Terbinafine 1% FFS versus Vehicle Meta-analysis Terbinafine 1% Cream versus Vehicle
Study Name Difference in Cure Rates* Study Name Difference in Cure Rates*
Feuilhade, 2006
3
Evans, 1991
10
Ortonne, 2006
2
Berman, 1992
11
Total terbinafine 1% FFS Korting ,2001
12
-100% -50% 0% 50% 100%
Total terbinafine 1% cream
Favours vehicle Favours
terbafine 1% FFS
-100% -50% 0% 50% 100%
Favours vehicle Favours
Meta-analysis Terbinafine 1% Cream, Solution or Gel versus Vehicle
terbafine 1% cream
Study Name Comparison Difference in Cure Rates*
Meta-analysis Naftifine 1% or Butenafine 1% versus Vehicle
Evans, 1991
10
Cream
Study Name Comparison Difference in Cure Rates*
Berman, 1992
11
Cream
Klaschka, 1983
19
Naftifine
Korting, 2001
12
Cream
Dobson, 1988
20
Naftifine
Foged, 1996 Solution
Schachner, 1990
21
Naftifine
Lebwohl, 2001
14
Solution
Bagatell A, 1991
22
Naftifine
Hollmen, 2002
15
Solution
Bagatell B, 1991
22
Naftifine
Total terbinafine
Savin, 1997
16
Butenafine
-100% -50% 0% 50% 100%
Favours vehicle Favours terbinafine 1% Tschen, 1997
17
Butenafine
cream, solution or gel
Reyes, 1998
18
Butenafine
Meta-analysis Azoles versus Vehicle
Study Name Comparison Difference in Cure Rates*
Total naftifine/butenafine
Coffey, 1986
23
Bifonazole
-100% -50% 0% 50% 100%
Favours vehicle Favours naftifine
Izuno, 1986
24
Bifonazole
or butenafine
Bagatelli, 1986
25
Bifonazole
Meta-analysis Ciclopiroxolamine versus Vehicle
Study Name Comparison Difference in Cure Rates*
Smith, 1986
26
Bifonazole
Kligman, 1985
35
Cream
Ison, 1990
27
Econazole
Aly, 2003
36
Gel
Gentles, 1975
28
Miconazole
Gupta, 2005
37
Gel
Ortiz, 1978
29
Miconazole
Total ciclopiroxolamine
Smith, 1977
30
Clotrimazole
-100% -50% 0% 50% 100%
Spiekermann A, Clotrimazole
Favours vehicle Favours
ciclopiroxolamine
1976
31
*Difference in mycological cure rates between active treatment and vehicle.
Spiekermann B, Clotrimazole
1976
31 imbalance between treatment groups in these atypical cases). With
the Klaschka study excluded, the difference from vehicle in
Smith, 1988
32
Tioconazole
mycological cure rates was 46.9±4.7% (95% CI 37.6–56.1%). With the
Ellis, 1989
33
Oxiconazole Klaschka study included, the corresponding figures were
Elewski, 1996
34
Oxiconazole
55.6±12.8% (95% CI 30.5–80.6%). When the butenafine and naftifine
studies were analysed as a group, with the discrepant Klaschka
Total azoles
study included, the overall difference from vehicle in mycological
-100% -50% 0% 50% 100%
cure rates was 51.6±9.0% (95% CI 34.0–69.2%). With the Klaschka
Favours vehicle Favours azoles
study excluded, the corresponding figures were 45.8±4.0% (95% CI
In the studies with naftifine, the data from Klaschka
19
were notably 37.8–53.7%). The results of the meta-analysis of this group are
inconsistent with those from the other studies, largely because the illustrated in Figure 1, with the Klaschka study included to show the
mycological cure rate with vehicle in this study was zero and degree of discrepancy.
the mycological cure rate with naftifine was the highest observed in
these studies, reaching 96.7%, leading to a difference from The Azoles
vehicle in mycological cure rates of 96.7±4.5%. In the studies with bifonazole, there was a high degree of
inconsistency, attributable mainly to the difference from vehicle in
The causative organisms in this study included Candida albicans in mycological cure rates of 67.6%±10.0% in the report by Smith.
26
The
five cases in the vehicle group and one in the naftifine group, casting overall difference from vehicle in mycological cure rates was
doubt on the true diagnosis of tinea pedis (and indicating an 43.9%±10.2% (95% CI 23.9–3.9%).
22 EUROPEAN DERMATOLOGY
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