Itraconazole effective for ringworm of the body but requires longer treatment

Itraconazole appears to be effective in the treatment of patients with tinea corporis/cruris (TCC) or ringworm of the body, as shown in a study. However, the treatment duration needs to be longer and, even with successful treatment, many patients experience relapse.

The study included 149 patients (mean age 34.3 years, 46.4 percent female) with treatment-naïve TCC involving at least 5-percent body surface area. They were randomized to receive itraconazole at 100, 200, or 400 mg per day.

Researchers conducted biweekly assessments to measure the main study endpoints—cure rates, treatment durations, safety profiles, and relapse rates. They followed the patients for at least 8 weeks after treatment to record relapses. Secondary endpoints included time to clinical response and cost-effectiveness.

Cure rates were comparable in the 100- and 200-mg groups (hazard ratio [HR], 1.44, 95 percent confidence interval [CI], 0.91–2.30; p=0.12). Meanwhile, the 400-mg group had significantly higher cure rate as compared with both the 100-mg group (HR, 2.87, 95 percent CI, 1.78–4.62; p<0.001) and the 200-mg group (HR, 1.99, 95 percent CI, 1.28–3.09; p=0.002).

Likewise, mean treatment durations were much shorter with the 400-mg dose relative to the 100-mg dose (5.2 vs 7.7 weeks; p=0.03) and the 200-mg dose (5.2 vs 7.2 weeks; p=0.004); there was no significant difference between the 100- and 200-mg dose groups.

Relapse occurred in 55 patients (47.4 percent), with comparable rates across the three groups. None of the patients discontinued treatment due to adverse effects.

In terms of cost-effectiveness, treatment with the 200- and 400-mg doses were associated with 63-percent and 120-percent higher costs, respectively, compared with 100 mg at achieving cure.