New drug tested at UCSF cures most disfiguring nail infections.
Now, thanks to a promising new drug vigorously tested at UC San Francisco, Turrentine says he no longer hides his feet in embarrassment. The drug--itraconazole--was recently approved by the Food and Drug Administration (October 1995).
"I had fungal nail disease and tried nearly everything to treat it," he says, "but the condition only worsened to where I was uncomfortable standing on my feet all day at work."
"Many patients have lived for years with the pain and humiliation of nails destroyed by fungal nail disease because little could be done for them," says Raza Aly, PhD, UCSF professor of dermatology and microbiology, who conducted the clinical trial of the drug at UCSF.
"Itraconazole is the first therapy to offer patients hope by providing a high level of efficacy in about one-fifth of the treatment time of other current therapies," he says.
Traditionally, with nail infection comes long treatment periods, drugs that show minimal results, and side effects such as gastrointestinal upset, headaches, taste disturbance and photosensitivity, according to Aly.
"Until now, few medications reached two important locations in the nail--the nail matrix and the nail bed--in adequate concentrations for long enough duration to rid invading fungus," Aly says. "Itraconazole is more effective, causes few side effects, and has a shorter treatment period than other oral agents used to treat nail disease."
Itraconazole is active against parasitic fungi like the kind that infects the toenails. Taken orally, the drug metabolizes in the liver and is distributed extensively to tissues.
"The drug gets into the nail bed quickly and remains there for up to six months after the treatment period ends," Aly says. "Depending on the dosage, the treatment period usually lasts up to three months."
In the past, patients had to take drugs until the infected nail grew out, which would be from six to nine months for fingernail infection and 12 to 18 months in toenail disease.
Aly says he has seen amazing results with itraconazole. "In about 80 percent of the patients, the nails have cleared up completely."
Fungal nail disease is the most common nail disorder, affecting nearly 11 million Americans. It can affect toenails, fingernails or both, causing the nails to become discolored, thick, brittle and sometimes detached from the nail bed.
People get the disease--called onychomycosis--simply by "picking up" fungi that lurk in bathing areas, dressing rooms, restrooms and other communal areas.
The fungi live in warm, moist environments such as health clubs, gymnasiums or pools and can be spread from one person to another, according to Aly.
"Fungal nail infection is essentially a disease of the developed world," Aly says. "In a society in which its citizens wear shoes, play sports and join fitness centers, nail infection is almost unavoidable."
Wearing artificial fingernails can also lead to fungal nail disease. "The artificial nails, or the glues used with them, can cause the natural nail plate to separate from the nail bed, and make it easy for fungus to enter," Aly says.
Fungal nail infection affects a wide variety of people, but its incidence increases with age. Up to 30 percent of those aged 60 or older has the disease. It affects men and women equally.
"The disease may have a genetic component that predisposes individuals to acquiring the infection," Aly says. Others at risk are people who are immunocompromised, such a those with AIDS and cancer, because their bodies are less able to resist infections.
Itraconazole is marketed under the brand name Sporanox, which is manufactured by Janssen Pharmaceutica, Inc., Titusville, N.J., a subsidiary of Johnson & Johnson.
CONTACT: University of California, San Francisco
Rebecca Higbee, 415/476-2557
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|Date:||Nov 2, 1995|
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