However, the 95% CI indicates that ciclopirox lacquer may actually make little or no difference (RR 1.61, 95% CI 0.89 to 2.92 low‐quality evidence).Įfinaconazole 10% solution is more effective than vehicle in achieving complete cure (RR 3.54, 95% CI 2.24 to 5.60 3 studies, 1716 participants) and clinical cure (RR 3.07, 95% CI 2.08 to 4.53 2 studies, 1655 participants) (both high‐quality evidence) and is probably more effective in achieving mycological cure (RR 2.31, 95% CI 1.08 to 4.94 3 studies, 1716 participants moderate‐quality evidence). ![]() ![]() Ciclopirox lacquer may lead to increased adverse events, commonly application reactions, rashes, and nail alteration (e.g. We present results for key comparisons, where treatment duration was 36 or 48 weeks, and clinical outcomes were measured at 40 to 52 weeks.īased on two studies (460 participants), compared with vehicle, ciclopirox 8% lacquer may be more effective in achieving complete cure (risk ratio (RR) 9.29, 95% confidence interval (CI) 1.72 to 50.14 low‐quality evidence) and is probably more effective in achieving mycological cure (RR 3.15, 95% CI 1.93 to 5.12 moderate‐quality evidence). The most common high‐risk domain was performance bias. We rated three studies at low risk of bias across all domains. Most studies assessed topical treatments, 9% devices, and 11% both. Forty‐three studies were carried out in outpatient settings. ![]() Thirty‐five studies specifically examined dermatophyte‐caused onychomycosis. Most studies lasted 48 to 52 weeks 23% reported disease duration (variable). Participants had more than one toenail affected. We included 56 studies (12,501 participants, average age: 27 to 68 years), with mainly mild‐to‐moderate onychomycosis without matrix involvement (where reported).
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