Terbinafine
| 證據等級: L5 | 預測適應症: 10 個 |
目錄
Terbinafine: From Fungal Skin Infections to Creeping Myiasis
One-Sentence Summary
Terbinafine is an allylamine-class antifungal, with a pharmacology described in the available evidence as inhibiting squalene epoxidase (fungicidal action against dermatophytes). The TxGNN model’s top-ranked prediction is Creeping Myiasis, but this candidate is supported by 0 clinical trials and 0 publications, and the underlying evidence pack itself flags the mechanistic link as absent — creeping myiasis is caused by migrating fly larvae, not fungi.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not available from SAHPRA licensing data (drug not registered in South Africa); evidence pack characterizes terbinafine as an antifungal for dermatophyte/fungal skin infections |
| Predicted New Indication | Creeping Myiasis |
| TxGNN Prediction Score | 96.74% |
| Evidence Level | L5 |
| South Africa Market Status | Not Marketed |
| Number of SAHPRA Registrations | 0 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
The formal DrugBank mechanism-of-action field is a data gap. However, the evidence pack’s own rationale notes consistently describe terbinafine as an allylamine-class antifungal that inhibits squalene epoxidase, blocking ergosterol synthesis in fungal cell membranes — a mechanism validated for dermatophyte infections (tinea, onychomycosis) elsewhere in this same evidence set (see ranks 8 and 10 below).
For the top-ranked candidate, creeping myiasis, the evidence pack explicitly states this prediction is not mechanistically supported: creeping myiasis results from subcutaneous migration of fly larvae, a parasitic/entomological process entirely unrelated to fungal ergosterol synthesis. No clinical trials and no literature exist for this drug-disease pair; the signal is a pure TxGNN model output (data-driven pattern in the knowledge graph) rather than a biologically grounded hypothesis.
In short, this is a case where the model’s highest-scoring prediction does not correspond to its most credible one — the evidence pack itself surfaces stronger, mechanistically coherent candidates further down the ranking (see note in Conclusion).
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
South Africa Market Information
Terbinafine currently has 0 SAHPRA registrations and is recorded as not marketed in South Africa. No product licenses or approved indication text are available in this evidence pack to summarize.
Safety Considerations
Please refer to the SAHPRA-approved Professional Information (PI) for safety information. Report adverse drug reactions to SAHPRA.
Conclusion and Next Steps
Decision: Hold
Rationale: The top-ranked prediction (creeping myiasis) has no mechanistic plausibility, no clinical trials, and no supporting literature — it is a model-score-only (L5) signal, and the evidence pack’s own analysis states the antifungal mechanism does not apply to a fly-larvae parasitic condition.
To proceed, the following is needed:
- Independent parasitological/entomological rationale for any anti-myiasis effect of terbinafine, if one is to be pursued
- SAHPRA-approved PI (warnings, contraindications) — currently a blocking data gap
- Formal DrugBank MOA confirmation
- SAHPRA registration/market authorization, since terbinafine is currently not marketed in South Africa
Note: Within this same evidence pack, other TxGNN-predicted indications for terbinafine show materially stronger support and may warrant separate evaluation — notably superficial mycosis (L2, one completed comparative trial vs. itraconazole, extensive literature, “Proceed with Guardrails”) and tinea manuum (L2, “Proceed with Guardrails”), both mechanistically consistent with terbinafine’s established antifungal activity.
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.