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Continuous terbinafine was more effective than intermittent itraconazole for curing toenail onychomycosis

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Evans EG, Sigurgeirsson B, for the LION Study Group. Double blind, randomised study of continuous terbinafine compared with intermittent itraconazole in treatment of toenail onychomycosis. BMJ. 1999 Apr 17;318:1031-5.

Question

In patients with toenail onychomy-cosis, does continuous terbinafine heal infection better than intermittent itraconazole?

Design

Randomised (concealed), blinded (patients and outcome assessors), controlled trial with 72-week follow-up.

Setting

35 centres in 6 countries (Finland, Germany, Iceland, Italy, the Netherlands, and the United Kingdom).

Patients

507 patients who were 18 to 75 years of age and had a clinical, mycologically confirmed diagnosis of toenail onychomycosis with an affected great toenail capable of regrowth. Exclusion criteria included infections other than dermatophyte infection; use of systemic or topical antifungal treatment within the previous 12 months and 4 weeks, respectively; use of drugs that might interact with study drugs; systemic conditions that might alter the pharmacodynamics of study drugs; …

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