A Multi-centre, Double-blind, Randomized, Vehicle-controlled Study of Efficacy and Safety of Topical MOB015B in the Treatment of Mild to Moderate Distal Subungual Onychomycosis (DSO)
A Multi-centre, Double-blind, Randomized, Vehicle-controlled Study of Efficacy and Safety of Topical MOB015B in the Treatment of Mild to Moderate Distal Subungual Onychomycosis (DSO)
The primary objective of this study is to evaluate the efficacy of topical MOB015B in
 patients with mild to moderate distal subungual onychomycosis (DSO).

 The secondary objective is to evaluate the safety of topical MOB015B in patients with mild to
 moderate DSO.
Male or female subjects aged between 12 and 75 years with confirmed DSO involving 20-60% of
 at least one great toenail will be screened for randomization in this study. The diagnosis of
 DSO will be confirmed prior to randomization through a positive culture of dermatophytes. In
 addition, a central blinded assessment of the clinical disease involvement (i.e., affected
 nail area) will be performed at Screening. Subjects have to meet all eligibility criteria
 before being randomized in to the study.

 Eligible subjects will be randomized to the investigational medicinal products (MOB015B or
 vehicle) in a ratio of 2:1. The investigational medicinal products (IMPs) will be applied to
 all affected fingernails and/or toenails for 48 weeks once daily at bedtime. However,
 fingernails will not be assessed for efficacy.

 Since both the IMPs are indistinguishable in appearance and mode of administration, the study
 will be performed as a double-blind study, i.e., both the investigator and the subject will
 remain blinded throughout the entire study.

 After a 4-week follow-up period without IMP treatment the end of study (EoS) Visit will be
 performed at Week 52 (Visit 7). The primary efficacy variable will be assessed at Week 52.
 The end of the clinical study for each individual subject is defined as the EoS Visit at Week
 52 (Visit 7). The end of the clinical study is defined as the last visit of the last subject
 in the study.
Inclusion Criteria:

 1. Males or females 12 - 75 years of age

 2. Distal subungual onychomycosis (DSO) of at least one of the great toenail(s) affecting
 20% to 60% of the target nail

 3. Positive culture for dermatophytes

 4. Written informed consent

 Exclusion Criteria:

 1. Proximal subungual onychomycosis

 2. Distal subungual onychomycosis of both great toenails where involvement has extended
 into the proximal portion of the target nail (unaffected proximal nail is less than 3
 mm)

 3. Target toenail thickness more than 3 mm

 4. "Spike" of onychomycosis extending to eponychium of the target toenail

 5. Presence of dermatophytoma (defined as thick masses of fungal hyphae and necrotic
 keratin between the nail plate and nail bed) on the target nail

 6. Other conditions than DSO known to cause abnormal nail appearance

 7. Presence of toenail infection other than dermatophytes

 8. Previous target toenail surgery with any residual disfigurement

 9. Topical treatment of the nails with other antifungal medication within 6 weeks before
 screening/Visit 1

 10. Systemic use of antifungal treatment within 6 months before screening/visit 1

 11. Severe moccasin tinea pedis

 12. Signs of severe peripheral circulatory insufficiency

 13. Uncontrolled diabetes mellitus

 14. Known immunodeficiency

 15. Participation in another clinical trial with an investigational drug or device during
 the previous 3 months before Baseline/ Visit 2

 16. Known allergy to any of the tested treatment products

 17. A positive pregnancy test at Baseline/Visit 2 indicating pregnancy in a woman of
 childbearing potential or a premenarche subject

 18. Females who are pregnant or breastfeeding

 19. Men who have female sexual partners of child-bearing potential and sexually active
 women of child-bearing potential who are not practicing an acceptable method of birth
 control, or who will not remain abstinent through the trial.

 20. Patients previously randomized in this study

 21. History of, or current drug or alcohol abuse

 22. Psychiatric condition that might limit the participation in the study and/or that lead
 to the assumption that the patient's ability to completely understand the consequences
 of consent is missing

 23. Close affiliation with the investigator (e.g. a close relative) or persons working at
 a study site, or patient who is an employee of the sponsor's company

 24. Patients who are institutionalized because of legal or regulatory order

 25. Any diseases or circumstances in which the patient should not participate in the study
 in the opinion of the investigator