Evidence map›Paper›PMID 41156660›Full record

ArticlePathogens (Basel, Switzerland)2025

Efficacy and Safety of Voriconazole for Difficult-to-Treat Distal Lateral Subungual Onychomycosis (DLSO).

Aditya K Gupta, Mesbah Talukder, Elizabeth A Cooper, Lee Magal, Avner Shemer

Abstract read
In one paragraph

Article in Pathogens (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Aditya K GuptaDivision of Dermatology, Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.ORCID 0000-0002-8664-7723
Mesbah TalukderSchool of Pharmacy, BRAC University, Dhaka 1212, Bangladesh.
Elizabeth A CooperDepartment of Physiology and Pharmacology, University of Western Ontario, London, ON N6A 5C1, Canada.ORCID 0000-0002-1121-5619
Lee MagalShemer Clinic, Netanya 4250602, Israel.
Avner ShemerDepartment of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This retrospective case series evaluated off-label voriconazole for distal lateral subungual onychomycosis (DLSO) unresponsive to standard therapy. Twenty-nine culture-confirmed patients who had failed terbinafine (250 mg daily × 12 weeks) and itraconazole pulses (200 mg twice daily for 1 week/month × 3) received voriconazole (200 mg twice on day 1, then 200 mg daily for 3-4 months). Assessments occurred at 2, 4, 6-9, and 12 months; the primary endpoint was combined clinical cure (≥90% nail clearance) plus mycological cure (negative KOH and culture) at 12 months. Intention-to-treat included 29 patients; per-protocol included 27 (two did not complete follow-up). In the per-protocol cohort, combined cure was 55.6% (15/27) and mycological cure 74.1% (20/27). Complete clinical cure occurred in 66.7% (18/27); 25.9% (7/27) improved markedly, 3.7% (1/27) mildly, and 3.7% (1/27) showed no improvement. Voriconazole was well tolerated and may be considered for DLSO refractory to terbinafine ± itraconazole. Antifungal stewardship remains essential.

Indexed as

Antifungal AgentsOnychomycosisVoriconazoleAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesTerbinafineTreatment OutcomeYoung AdultAntifungal AgentsTerbinafineVoriconazoleclinical curedistal lateral subungual onychomycosis (DLSO)mycological curerefractory onychomycosisterbinafine failurevoriconazole

Identifiers

PMID41156660
PMCPMC12566913

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.