Effectiveness and safety of ciclopirox olamine in patients with dermatophytosis: a retrospective cohort analysis
Keywords:Ciclopirox olamine, Dermatophytosis, Effectiveness, Safety
Background: The current scenario of dermatophytosis is alarming, despite the availability of multiple antifungal agents the management of dermatophytosis is still challenging. Hence there is a need for a different antifungal with a novel mechanism of action for the management of dermatophytosis.
Methods: It was retrospective cohort study where in record of patients with dermatophytosis who were candidates for topical therapy only were analysed. All the patients were treated with Ciclopirox olamine 1% twice daily for 6 weeks. The efficacy end points were complete cure rate, mycological cure rate and clinical cure rate.
Results: 613 patients were included in the final analysis. At the end of study period the complete, mycological and clinical cure rates were 73.89%, 75.37% and 77.65% respectively. Out of 613 patients included 528 patients showed treatment failure to previous topical antifungal agents while 84 patients were treatment naïve. In treatment failure patients the complete, mycological and clinical cure rates were 72.15%, 73.48, and 75.56% respectively. In treatment naïve patients the complete, mycological and clinical cure rates were 84.70%, 87.05% and 90.58% respectively. 5.70% reported adverse events. The most common adverse event was pruritus followed erythema, dryness and rash.
Conclusions: Results of this study proves that ciclopirox is efficacious and safe in the management of dermatophytosis. This study also proves that ciclopirox is useful in those patients who failed to respond to other topical antifungal agents.
Rajagopalan M, Inamadar A, Mittal A, Miskeen AK, Srinivas CR, Sardana K, et al. Expert Consensus on The Management of Dermatophytosis in India (ECTODERM India). BMC Dermatol. 2018;18(1):6.
Verma S, Madhu R. The Great Indian Epidemic of Superficial Dermatophytosis: An Appraisal. Indian J Dermatol. 2017;62(3):227-36.
Dogra S, Uprety S. The menace of chronic and recurrent dermatophytosis in India: Is the problem deeper than we perceive? Indian Dermatol Online J. 2016;7(2):73-6.
Das A, Sil A, Sarkar TK, Sen A, Chakravorty S, Sengupta M et al. A randomized, double-blind trial of amorolfine 0.25% cream and sertaconazole 2% cream in limited dermatophytosis. Indian J Dermatol Venereol Leprol. 2019;85:276-81.
Sahoo AK, Mahajan R. Management of tinea corporis, tinea cruris, and tinea pedis: A comprehensive review. Indian Dermatol Online J. 2016;7(2):77-86.
Korting HC, Grundmann-Kollmann M. The hydroxypyridones: a class of antimycotics of its own. Mycoses. 1997;40(7-8):243-7.
Subissi A, Monti D, Togni G, Mailland F. Ciclopirox: recent nonclinical and clinical data relevant to its use as a topical antimycotic agent. Drugs. 2010;70(16):2133-52.
Gupta AK, Skinner AR. Ciclopirox for the treatment of superficial fungal infections: a review. Int J Dermatol. 2003;42(1):3-9.
Bagatell FK, Bogaert H, Cullen SI. Evaluation of a new antifungal cream, Ciclopirox Olamine 1% in the treatment of cutaneous candidosis. Clin Ther. 1985;8:41-8.
Kligman AM, Bogaert H, Cordero C. Evaluation of Ciclopirox Olamine cream for the treatment of tinea pedis: multicentre, double-blind, comparative studies. Clin Ther. 1985;7:409-17.
Cullen SI, Jacobson C, Kanof NB. Treatment of tinea versicolor with a new antifungal agent, Ciclopirox Olamine cream 1%. Clin Ther. 1985;7:574-83.
Corte M, Jung K, Linker U. Topical application of a 0.1% Ciclopirox Olamine solution for the treatment of pityriasis versicolor. Mycoses. 1989;32(4):200-3.
Gupta AK, Kohli Y. In vitro susceptibility testing of ciclopirox, terbinafine, ketoconazole and itraconazole against dermatophytes and nondermatophytes, and in vitro evaluation of combination antifungal activity. Br J Dermatol. 2003;149:296-305.
Sonthalia S, Agrawal M, Sehgal VN. Topical Ciclopirox Olamine 1%: Revisiting a Unique Antifungal. Indian Dermatol Online J. 2019;10(4):481‐85.
Ghelardi E, Celandroni F, Gueye SA, Salvetti S, Senesi S, Bulgheroni A, et al. Potential of Ergosterol synthesis inhibitors to cause resistance or cross-resistance in Trichophyton rubrum. Antimicrob Agents Chemother. 2014;58(5):2825-9.
Adimi P, Hashemi SJ, Mahmoudi M, Mirhendi H, Shidfar MR, Emmami M, et al. In-vitro activity of 10 antifungal agents against 320 dermatophyte strains using microdilution method in Tehran. Iran J Pharm Res. 2013;12:537-45.