Comparison of Efficacy and Safety Between Methylene Blue-mediated Photodynamic Therapy and 5% Amorolfine Nail Lacquer for Toenail Onychomycosis Treatment

NCT ID: NCT03098342

Last Updated: 2017-03-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-06-01

Study Completion Date

2019-01-31

Brief Summary

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Study centre and address

King Chulalongkorn Memorial Hospital

Primary objective

To compare the efficacy and the safety of methylene blue-mediated photodynamic therapy and 5% amorolfine nail lacquer for toenail onychomycosis in Asians

Detailed Description

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• Research Design

Randomized, single-blind clinical trial

• Research Methodology

Target population

* 42 Patients, aged between 18-90 years old, with distal and lateral subungual toenail onychomycosis diagnosed clinically and mycologically
* Patients were recruited from Dermatology clinic, King Chulalongkorn Memorial Hospital

* Exclusion criteria

1. Those with nail changes because of skin disease or associated systemic diseases
2. Those who had previously used anti-fungal medications within 3 months for systemic and 1 month for topical therapy.
* Methods

1. Patients will be informed of the details of the study including predicted possible adverse events due to the treatments and primary aids.
2. They will be included in stratified randomly by poor prognostic factors, then divided into two groups (A: methylene blue-mediated photodynamic therapy (MB-PDT) and B: 5% Amorolfine Nail Lacquer by block randomization of size 4 and 6.
3. For 24 weeks,
* Group A

* The use of PDT consisting of 6 treatment sessions with interval of 15 days between each session
* Patient will be instructed that apply 40% urea cream under occlusive dressing for 5 days prior to PDT.
* Group B

* Patients will be detailed instruction regarding the use of 5% Amorolfine Nail Lacquer as its recommended protocol.
* Total duration of the follow-up is 18 months

Evaluation tool

* Nail photographs by using dermoscope for onychomycosis severity index (OSI) evaluation
* Either Scrape or nail clipping, which is positive prior to the treatment, will be performed for microscopic study and culture.
* Safety will be assessed through adverse events.
* Patients' satisfaction will be evaluated at the end of the treatment.

Conditions

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Onychomycosis of Toenail

Keywords

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Onychomycosis photodynamic therapy methylene blue amorolfine, nail lacquer Asians

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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MB-PDT for Onychomycosis

Group Type EXPERIMENTAL

Methylene blue-mediated photodynamic therapy

Intervention Type PROCEDURE

Using the 2% MB aqueous solution as a photosensitiser. After the rest period, the lesion was immediately illuminated with incoherent red light (peak emission spectrum at 630-640 nm)

Amorolfine for Onychomycosis

Group Type ACTIVE_COMPARATOR

Amorolfine 5% Nail Lacquer

Intervention Type DRUG

Patients will be detailed instruction regarding the use of 5% Amorofine Nail Lacquer (Loceryl®) as its recommended protocol.

Interventions

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Methylene blue-mediated photodynamic therapy

Using the 2% MB aqueous solution as a photosensitiser. After the rest period, the lesion was immediately illuminated with incoherent red light (peak emission spectrum at 630-640 nm)

Intervention Type PROCEDURE

Amorolfine 5% Nail Lacquer

Patients will be detailed instruction regarding the use of 5% Amorofine Nail Lacquer (Loceryl®) as its recommended protocol.

Intervention Type DRUG

Other Intervention Names

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Incoherent red light (peak emission spectrum at 630-640 nm) Methylene blue

Eligibility Criteria

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Inclusion Criteria

* Patients, aged between 18-90 years old, with distal and lateral subungual toenail onychomycosis diagnosed clinically and mycologically

* Clinical signs of onychomycosis as following:

* Discoloration
* Dystrophy of nail plate
* Subungual hyperkeratosis
* Onycholysis
* Confirmed by:

* Positive culture of dermatophyte or non-dermatophyte (must be isolated from sequential specimens) and/or
* Positive microscopic evidence\*
* \*any of these methods, direct microscopy (KOH preparation), nail plate culture on Sabouraud's dextrose agar (SDA), histopathological examination of nail clippings using PAS staining (HPE-PAS), histopathological examination of nail clippings using GMS staining (HPE-GMS), polymerase chain reaction

Exclusion Criteria

* Those with nail changes because of skin disease or associated systemic diseases
* Pregnancy or lactating woman
* Those who are allergic to amorolfine, methylene blue
* Those who are photosensitive to visible light
* Those who had previously used anti-fungal medications within 3 months for systemic and 1 month for topical therapy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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King Chulalongkorn Memorial Hospital

OTHER

Sponsor Role collaborator

Chulalongkorn University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Natthamon Bowornsathitchai, MD

Role: PRINCIPAL_INVESTIGATOR

Chulalongkorn University

Locations

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King Chulalongkorn Memorial Hospital

Bangkok, Bangkok, Thailand

Site Status

Countries

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Thailand

Central Contacts

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Einapak Amnarttrakul, MD

Role: CONTACT

Phone: 7521182743

Email: [email protected]

Pravit Asawanonda, MD, PhD

Role: CONTACT

Phone: 66818129393

Email: [email protected], [email protected]

Facility Contacts

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Nutthamon Bowornsathitchai, M.D.

Role: primary

Jaruwan Pemcharoen, B.Sc.

Role: backup

Other Identifiers

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CU_MBPDT_for_Onychomycosis

Identifier Type: -

Identifier Source: org_study_id