Hepatotoxicity and acute kidney injury associations with itraconazole, voriconazole and posaconazole in the treatment of Onychomycosis: pharmacovigilance study of FDA adverse event reporting system data (FAERS)

Abstract

Infections caused by fungi typically affect the skin, nails, and lungs but they can also penetrate the skin, infect the organs and spread throughout the body but research has found that dermatophytosis of the toenails and fingernails, known as onychomycosis, is more challenging to treat with medication than fungal infections of other body parts. Due to their high cure rates and safety profiles, azole antifungals replaced topical treatments in treating onychomycosis. However, studies suggest these medicines cause Hepatotoxicity and Acute kidney injury. In this study information from the FAERS database is analyzed using a reporting odds ratio (ROR) to identify potential danger signs. Hepatotoxicity Reporting odds ratio for drug's were, Voriconazole 8.16 (6.29, 10.60) > Itraconazole 3.98 (1.99, 7.96) > Posaconazole 3.23 (1.62, 6.47). Additionally, Acute kidney Injury Reporting odds ratio for selected drug were, Voriconazole 0.46 (0.33, 0.65) > Posaconazole 0.37 (0.19, 0.71) > Itraconazole 0.10 (0.03, 0.40).