The effectiveness of antifungal drugs in dermatomycosis: a systematic review with network analysis

Dermatomycosis has a significant impact on the quality of life of patients of any age in all socio-economic regions and requires therapy. Aim of the review — to compare the effectiveness of topical therapy of dermatomycosis with amorolfine, azole (clotrimazole, ketoconazole) and allylamine (terbinafine, naftifine) groups using a systematic review of randomized clinical trials and synthesis of its results based on a network meta-analysis. The review includes non-placebo-controlled randomized trials of the efficacy of amorolfine, clotrimazole, ketoconazole, terbinafine, and naftifine with a therapy duration of up to four weeks. The percentage of patients who achieved a mycological and clinical cure was chosen as the endpoint of effectiveness. The assessment of the effect size in the analysis is represented by the risk difference. The drugs in question are ranked based on surface under the cumulative ranking curve (SUCRA). The data from 7 studies involving about 769 patients with dermatomycosis were statistically analyzed. The results showed almost equivalent efficacy of amorolfine and terbinafine, superior to ketoconazole, and clotrimazole in cream formulations. Ranking the effectiveness of drugs using SUCRA revealed amorolfine as the most effective therapy among other drugs. The analysis of the study results included in the systematic review showed the advantage of amorolfine in the formulation of cream over terbinafine, ketoconazole, clotrimazole, naftifine.