{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T14:29:44Z","timestamp":1780756184625,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Onychomycosis, a superficial fungal infection, develops when dermatophytes infect nail plate and beds. Fosravuconazole\n                    <jats:sc>l<\/jats:sc>\n                    \u2010lysine ethanolate (F\u2010RVCZ), a fourth\u2010generation azole antifungal agent with potent antifungal activity and few drug interactions, was highly effective in a clinical trial, with a complete cure rate of 59.4% at 48\u2009weeks after treatment initiation. However, some patients were not completely cured. To achieve a higher complete cure rate, additional therapy needs to be examined. We aimed to examine (i) the criteria for additional F\u2010RVCZ therapy in patients with an inadequate response to initial F\u2010RVCZ treatment for onychomycosis; (ii) the timing of additional therapy; and (iii) the effects of additional treatment. This was a multicenter, open\u2010label, three\u2010arm randomized clinical trial. Patients with onychomycosis were orally administered an approved dose of F\u2010RVCZ for 12\u2009weeks, and its efficacy was assessed at week 24. Patients who demonstrated \u226555% reduction in nail involvement ratio at week 24 were included in Group X and followed up. Patients with &lt;55% reduction were randomly assigned to follow\u2010up (Group A) or additional treatment (Group B) groups. The complete cure rate at week 72 in Group X was 73.3%. In Groups A and B, the complete cure rates were 29.6% and 46.7%, respectively, and were significantly different (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.0414, odds ratio 2.08). During the study, 63 adverse drug reactions were recorded in 59 of the 318 patients (18.6%), for which a causal relationship with F\u2010RVCZ could not be ruled out. In Group B, three of 75 patients (4.0%) experienced three adverse drug reactions, all observed during additional treatment; none were serious. A high complete cure rate is possible without additional F\u2010RVCZ treatment when nail involvement decreases by \u226555% at week 24; however, when the reduction is &lt;55% at week 24, additional F\u2010RVCZ treatment should be considered to improve the cure rate.\n                  <\/jats:p>","DOI":"10.1111\/1346-8138.17193","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T07:26:04Z","timestamp":1710401164000},"page":"964-972","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of additional oral fosravuconazole\n                    <scp>l<\/scp>\n                    \u2010lysine ethanolate therapy following inadequate response to initial treatment for onychomycosis: A multicenter, randomized controlled trial"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7835-1697","authenticated-orcid":false,"given":"Wataru","family":"Naka","sequence":"first","affiliation":[{"name":"Naka Dermatology Clinic  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3590-6489","authenticated-orcid":false,"given":"Yuichiro","family":"Tsunemi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Saitama Medical University Hospital  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.15618"},{"key":"e_1_2_9_3_1","first-page":"27","article-title":"Large\u2010scale epidemiological survey on the status of tinea pedis and tinea unguium and potential morbidity (foot check, 2007) [in Japanese]","volume":"26","author":"Naka W","year":"2009","journal-title":"JOCD"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3314\/mmj.53.185"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2009.00741.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2009.09315.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2004.00851.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1998.02464.x"},{"key":"e_1_2_9_9_1","first-page":"891","article-title":"Tinea pedis and onychomycosis frequency in diabetes mellitus patients and diabetic foot ulcers. A cross sectional \u2013 observational study","volume":"32","author":"Akkus G","year":"2016","journal-title":"Pak J Med Sci"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2031"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.142.10.1279"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.13358"},{"key":"e_1_2_9_13_1","first-page":"187","article-title":"Pharmacological characteristics and clinical utility\u00a0of fosravuconazole L\u2010lysine ethanolate as a new oral therapeutic for onychomycosis [in Japanese]","volume":"27","author":"Yamaguchi H","year":"2019","journal-title":"Jpn J Antibiot"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.14607"},{"key":"e_1_2_9_15_1","first-page":"347","article-title":"Liver function test algorithm for administration of the novel oral azole onychomycosis agent fosravuconazole L\u2010lysine ethanolate [in Japanese]","volume":"39","author":"Tsunemi Y","year":"2019","journal-title":"Prog Med"},{"key":"e_1_2_9_16_1","first-page":"55","article-title":"A randomized, double\u2010blind, parallel\u2010group comparison study of itraconazole pulse therapy with a one\u2010year follow\u2010up for toenail onychomycosis: optimal dosages and cycles [in Japanese]","volume":"114","author":"Watanabe S","year":"2004","journal-title":"Jpn J Dermatol"},{"key":"e_1_2_9_17_1","volume-title":"ImageJ","author":"Rasband WS","year":"1997"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nmeth.2089"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.15651"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.2336\/nishinihonhifu.80.470"},{"key":"e_1_2_9_21_1","first-page":"1113","article-title":"The study on additional pulse therapy for cases with remaining turbid toe nail after the first itraconazole pulse therapy [in Japanese]","volume":"51","author":"Tusnemi Y","year":"2009","journal-title":"Rinsho Derma"}],"container-title":["The Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.17193","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1346-8138.17193","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.17193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T07:56:09Z","timestamp":1770537369000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1346-8138.17193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,14]]},"references-count":20,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1111\/1346-8138.17193"],"URL":"https:\/\/doi.org\/10.1111\/1346-8138.17193","archive":["Portico"],"relation":{},"ISSN":["0385-2407","1346-8138"],"issn-type":[{"value":"0385-2407","type":"print"},{"value":"1346-8138","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,14]]},"assertion":[{"value":"2023-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}