Diagnosis of Onychomycosis and Real-World Data of Oral Fosravconazole in Japan

Abstract

In Japan, two topical drugs and three oral antifungal drugs are prescribed for onychomycosis. Fosravuconazole L-lysine ethanolate (F-RVCZ) is an azole antifungal drug that has been prescribed in Japan since 2018 for the oral treatment of onychomycosis. Herein, we review the real-world evidence of F-RVCZ treatment for cutaneous fungal infection in Japan. The number of prescriptions for F-RVCZ has been increasing. It is more effective than topical drugs and has a favorable safety profile. On the other hand, side effects include elevation of liver enzymes, such as γ-GTP, and renal dysfunction in aged patients. Real-world case reports suggest that F-RVCZ is effective in treating other forms of tinea such as tinea capitis and tinea corporis. The diagnosis of onychomycosis is typically based on KOH direct examination; however, the dermatophyte test strip is used in specific situations where microscopy is difficult to perform such as in house-call medical practice.

Keywords: fosravuconazole L-lysine ethanolate (F-RVCZ); onychomycosis; tinea corporis; tinea faciei; tinea pedis.