title: New pharmacotherapy for the treatment of onychomycosis: an update.
abstract: BACKGROUND
  Onychomycosis is an infection of the nail plate that is an important priority area for the development of antifungal drugs. The high incidence of relapse and reinfection often makes onychomycosis a chronic condition. The current gold standard is oral therapy, but the development of effective topical agents remains a priority as they have fewer systemic interactions.
  
  
  METHODS
  This review summarizes development of antifungals from early phase development through Phase III clinical trials for onychomycosis. The oral molecules in development are azole molecules. Topical drugs in development include azoles, allylamines, benzoxaboroles and nanoemulsions. Photosensitizers for photodynamic therapy and new laser systems are also emerging therapeutic options. There is a diverse array of antifungal drugs in the early phases of development.
  
  
  CONCLUSIONS
  The goals of onychomycosis therapy are a mycological cure and a normal appearing nail. The recent development of topical antifungals has been successful at improving the nail permeation and efficacy. The diversification of molecular targets is the next primary goal of antifungal development. Incomplete treatment of onychomycosis provides an environment conducive to the development of antifungal resistance. New topical agents and device-based therapies expand the therapeutic options. Combination therapy using multiple drug classes may improve the overall efficacy of antifungal treatment in onychomycosis.
authors.affiliation: Mediprobe Research, Inc. , 645 Windermere Rd, London, ON, N5X 2P1 , Canada +1 519 851 9715 ; +1 519 657 4233 ; agupta@execulink.com.
authors.forename: Aditya K
authors.initials: AK
authors.lastname: Gupta
authors.forename: Fiona C
authors.initials: FC
authors.lastname: Simpson
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D028022:Low-Level Light Therapy; D014009:Onychomycosis / Q000188:drug therapy* / Q000532:radiotherapy; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D017319:Photosensitizing Agents
keywords: allylamine; antifungal; azole; dermatophyte; non-dermatophyte mold; onychomycosis