Efficacy and Safety of Efinaconazole 10% Solution in the Treatment of Onychomycosis in Diabetic Patients

Phase 3

Completed

Brief Summary: Onychomycosis, a common pathology of the toenails, is even more prevalent among diabetic subjects. Nearly 26 million Americans suffer from diabetes, and approximately one-third of subjects with diabetes have toenail onychomycosis. Numerous studies have addressed the efficacy and safety of both topical and oral antifungal treatment options for onychomycosis in diabetic subjects. However, no study to date has specifically addressed the efficacy and safety of efinaconazole among diabetic subjects.

The objective of this noncomparative, uncontrolled study is to determine the efficacy of topical efinaconazole 10% for toenail onychomycosis among subjects with diabetes mellitus. Specific indicators to measure efficacy of treatment will be the mycological cure rate, complete cure rate, and treatment success. Furthermore, an additional goal of the study is to gain knowledge of safety in the setting of a cohort of diabetic subjects

Recruitment & Eligibility

Inclusion Criteria

Clinical diagnosis of onychomycosis confirmed through positive KOH stain or positive mycologic culture findings.
Involvement of at minimum 20% of the target great toenail.

Exclusion Criteria

Diagnosis of a nondermatophyte fungus infection, diagnosis of proximal subungual onychomycosis, diagnosis of superficial white onychomycosis
Diagnosis of peripheral arterial disease or anatomic abnormalities of the target toenail
Inability to follow through with all requisite office visits
Routine use of a systemic corticosteroid, routine use of a systemic immunomodulator, or history of systemic antifungals within the prior five years.
Active interdigital tinea pedis refractory to topical antifungal treatments
Known hypersensitivity to efinaconazole
Use, within the month preceding screening, of: topical antifungal agents, topical anti-inflammatory agents to the toes
Any history of oral systemic antifungal with known activity against dermatophytes

Arm && Interventions

Group	Intervention	Description
Intervention Group, receiving medication	Efinaconazole Topical	Enrolled subjects with confirmed onychomycosis will be dispensed topical medication for treatment.

Primary Outcome Measures

Name	Time	Method
Primary Endpoint - Efficacy	50 weeks	The primary efficacy end point is the proportion of subjects achieving complete cure at week 50. Complete cure is to be defined as a combination of 0% clinical involvement and mycological cure (mycological cure defined as negative KOH examination and negative fungal culture of the target toenail sample).

Secondary Outcome Measures

Name	Time	Method
Secondary Endpoint - Efficacy	50 weeks	The second secondary efficacy end point is clinical cure, defined as 0% clinical involvement of the target toenail.
Secondary Endpoint - Safety (Occurrence of Adverse Events: Type and Frequency)	50 weeks	The secondary safety endpoint is the occurrence of adverse events (type and frequency).