Meta-analysis Of The Efficacy For Intermittent Of Terbinafine In The Treatment Of Dermatophyte Onychomycosis

OBJECTIVE: Meta-analysis was used to evaluate the clinical efficacy and safety of terbinafine in intermittent treatment of onychomycosis.METHODS: The computer retrieves the self-built library to the database on December 31,2018,including Pubmed,Embase,Corchrane library,Medline,China National Knowledge Infrastructure(CNKI),Wanfang,Weipu,CBM,with "Onychomycosis",“Lamisil”,"Terbinafine","intermittent","continuous","pulse(d)" and other English searches using keyword and free word search to search for randomized controlled trials(Randomized Controlled Trial,RCT)on the clinical treatment of terbinafine intermittent treatment of onychomycosis.We selected two independent researchers(postgraduates)to screen the searched documents based on pre-established inclusion and exclusion criteria,and to conduct quality evaluation and related data extraction based on Jadad’s latest score sheet.The raw data included were binary categorical variables.We used relative risk(RR)and 95% confidence interval(CI)to express the mycological cure rate and complete cure rate.This study used Review manager 5.3 software to analyze the data of terbinafine intermittent medication regimen versus classic medication regimen for onychomycosis.RESULTS: Finally,9 randomized controlled trials were included.A total of 2769 patients participated in the trial.Among them,2257 patients were evaluable patients.They were divided into experimental group(Intermittent group),terbinafine intermittent drug administration group and control group(Continuous group).,itraconazole group)(Tirbinafine continuous dosing regimen,itraconazole pulse group),1108 patients in the Intermittent group,1100 patients in the Continuous group,and 80 patients in the itraconazole group showed: terbinafine Compared with the continuous drug group of the terbinafine group,the combined effect of the mycological cure rate fell on the vertical line(RR = 0.90,95% CI 0.81-1.01,P = 0.07),no statistical difference,indicating that the terbinafine intermittent drug regimen group and the terbinafine continuous drug regimen group were similar in fungal clearance rate;the terbinafine intermittent drug group compared with the itraconazole group,the mycological cure rate combined effect The amount fell on the vertical line(RR 值 =1.19,95 % CI 0.99-1.44,P=0.07),no statistical difference,indicating that the terbinafine intermittent medication regimen group and the itraconazole pulse medication regimen group in the fungus The rate of elimination was similar;the complete cure rate: the combined effect of the terbinafine discontinuation group and the terbinafine continuous medication group fell on the vertical line(RR = 0.86,95% CI 0.74-1.01,P = 0.08),there was no statistically significant difference,indicating that the terbinafine intermittent medication regimen group and the terbinafine continuous medication regimen group were similar in complete cure rate,and the terbinafine intermittent medication group and the itraconazole vein group The combined effect rate of the complete cure rate falls to the right side of the vertical line(RR = 1.90,95% CI 1.26-2.86,P = 0.0002),and there is a statistically significant difference,indicating that the terbinafine intermittent medication regimen is completely cured.The rate was better than the itraconazole pulse medication group;the combined effect rate of adverse reaction rate fell on the vertical line(RR = 0.87,95% CI 0.73-1.03,P = 0.10),no significant statistical difference,indicating the special ratio The incidence of adverse reactions was similar between the naphthene discontinuation regimen regimen and the terbinafine continuous regimen regimen.CONCLUSION: Terbinafine discontinuous regimen in the treatment of onychomycosis may achieve consistent clinical efficacy and safety.