{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:23:08Z","timestamp":1790893388113,"version":"4.1.0"},"reference-count":52,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2022,11,1]]},"abstract":"<jats:sec><jats:title>Importance<\/jats:title><jats:p>With worldwide emergence of recalcitrant and resistant dermatophytosis, itraconazole is increasingly being used as the first-line drug for treatment of tinea corporis\/cruris (TCC). Apparent inadequacy with low doses has led to empirical use of higher doses and antifungal combinations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare cure rates, treatment durations, safety profiles, and relapse rates of itraconazole 100, 200, and 400 mg\/d for the treatment of TCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This double-blind randomized clinical trial included adult patients with treatment-naive TCC involving at least 5% body surface area. Patients were recruited from the dermatology outpatient department of a tertiary care hospital in New Delhi, India between March 1, 2020, and August 31, 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Patients were randomized to 1 of the 3 treatment groups. Biweekly blinded assessments were performed until cure or treatment failure. Posttreatment follow-up of at least 8 weeks was conducted to detect relapses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome and Measures<\/jats:title><jats:p>Cure rates, treatment durations, safety profiles, and relapse rates were assessed. Secondary outcomes included comparison of rapidity of clinical response and cost-effectiveness between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 149 patients assessed, the mean (SD) age was 34.3 (12.2) years, 69 patients (46.4%) were women, and 80 patients (53.6%) were men. The difference in cure rate between the 100- and 200-mg groups was statistically nonsignificant (hazard ratio [HR], 1.44; 95% CI, 0.91-2.30; <jats:italic>P<\/jats:italic>\u2009=\u2009.12), while the difference between the 100- and 400-mg groups (HR, 2.87; 95% CI, 1.78-4.62; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) and between the 200- and 400-mg groups (HR, 1.99; 95% CI, 1.28-3.09; <jats:italic>P<\/jats:italic>\u2009=\u2009.002) was statistically significant. Mean (SD) treatment durations were statistically significantly different between the 100- and 400-mg groups (7.7 [4.7] weeks vs 5.2 [2.6] weeks; <jats:italic>P<\/jats:italic>\u2009=\u2009.03) and between the 200- and 400-mg groups (7.2 [3.8] weeks vs 5.2 [2.6] weeks; <jats:italic>P<\/jats:italic>\u2009=\u2009.004), but the difference between the 100- and 200-mg groups was not statistically significant. A total of 55 patients (47.4%) relapsed after treatment. Relapse rates were comparable across groups. No patient discontinued treatment due to adverse effects. Treatment with the 200-mg dose incurred a 63% higher cost and 400 mg a 120% higher cost over 100 mg in achieving cure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this randomized clinical trial, high overall efficacy was observed among the 3 itraconazole doses for treatment of TCC, but with prolonged treatment durations and considerable relapse rates. Treatment with the 200- and 100-mg doses did not differ significantly in efficacy or treatment durations, while 400 mg scored over the other 2 on these outcomes. Considerable additional cost is incurred in achieving cure with the 200- and 400-mg doses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>Clinical Trials Registry of India Identifier: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/ctri.nic.in\/Clinicaltrials\/showallp.php?mid1=39207&amp;amp;amp;EncHid=&amp;amp;amp;userName=CTRI\/2020\/03\/024326\">CTRI\/2020\/03\/024326<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2022.3745","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T15:01:47Z","timestamp":1663167707000},"page":"1269","source":"Crossref","is-referenced-by-count":62,"title":["Effect of Different Itraconazole Dosing Regimens on Cure Rates, Treatment Duration, Safety, and Relapse Rates in Adult Patients With Tinea Corporis\/Cruris"],"prefix":"10.1001","volume":"158","author":[{"given":"Ananta","family":"Khurana","sequence":"first","affiliation":[{"name":"Department of Dermatology, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aastha","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diksha","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeet","family":"Panesar","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Dr Ram 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