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Fungal nail infection (onychomycosis) - Evidence
Evidence on oral terbinafine compared with placebo
Three randomized controlled trials (RCTs) found oral terbinafine to be more effective than placebo in treating toenail dermatophyte onychomycosis.
Systematic reviews (most recent search: June 2006) found five placebo-controlled RCTs that assessed the effectiveness of oral terbinafine for fungal toenail infection [Crawford et al, 2002; Crawford and Ferrari, 2007].
- Data could be pooled for three RCTs (n = 337) which compared terbinafine 250 mg daily with placebo for 12 weeks.
- Cure rates at the end of treatment were significantly increased compared with placebo:
- Cure rates: 63% compared with 20%, absolute difference 43% (95% CI 34% to 53%).
- The evidence was assessed as very low quality because of the possibility of publication bias, short follow up, and inconsistent definitions of cure [Crawford and Ferrari, 2007].
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