Bacterial Vaginosis (BV) is a common infectious disorder and is characterized by a disturbance in the vaginal microbiological milieu. Anaerobic bacteria, such as Gardnerella vaginalis and Atopobium vaginae overgrow the physiologic vaginal flora which is dominated by Lactobacilli. BV can arise and remit spontaneously but often presents as a recurrent disease. New findings indicate that the presence of an adherent bacterial biofilm on the vaginal mucosa seems to be the reason for the recurrence of BV as well as the overgrowth condition by anaerobic bacteria. Biofilms are defined as a structured consortium of bacteria embedded in a matrix of extracellular polymeric substances (EPS). The purpose of this study is to achieve substantial results with respect to tolerability and safety, and to gain further knowledge on the clinical efficacy of Vaginal suppository WO3191, the investigation will be performed in a parallel-design, double-blind, randomised, controlled manner.
This investigation is a multicentre, parallel-group, double-blind, controlled trial with an open Follow-up Phase of 12 weeks. It is conducted to gain clinical experience and further knowledge about the certified medical device Vaginal suppository WO3191 in women with bacterial vaginosis. In this investigation the Investigational Medical Device (IMD) will be used as post-treatment following standard therapy with oral metronidazole for BV. IMD will be applied 2 times a week for 3 weeks. The primary purpose is the evaluation of the safety and local tolerability of WO3191, therefore all adverse events (AEs) and adverse device effects (ADEs) will be documented. Furthermore, patients will be asked for possibly arising subjective vaginal symptoms (burning, itching, bleeding, pain, dryness) and will be examined for possibly arising objective vaginal findings (redness, petechial bleeding, dryness, swelling). The secondary purpose of this investigation is to gain clinical experience and further knowledge about Vaginal suppository WO3191 with respect to the efficacy in the post-treatment of bacterial vaginosis. In addition pH-values and microbiological data shall be examined. Furthermore, the difference between Vaginal suppository WO3191 (Group A) and the comparator (Vagisan® Lactic Acid, group B) with respect to the safety, tolerability and the efficacy in the post-treatment of bacterial vaginosis shall be evaluated exploratively. Patients who have completed all regular visits (Visit 1 - 4; Visit 1 - Screening, Visit 2 - Randomization, Start of application of IMD; Visit 3 - one week after Visit 2; Visit 4 - two weeks after Visit 3, End of application of IMD) of the investigation shall attend an observational Follow-up Phase of 12 weeks with a final Visit 5. At Visit 5 recurrences of BV as well as the sustainability of the efficacy of Vaginal suppository WO3191 will be evaluated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
43
application of vaginal suppository WO3191: 2 days per week (with a treatment-free interval of three days or two days, respectively; e.g. Monday and Friday)
application of Vagisan® Lactic Acid: 2 days per week (with a treatment-free interval of three days or two days, respectively; e.g. Monday and Friday)
Dr. Gerick
Aachen, Germany
Dr. Hofmann
Betzdorf, Germany
Dr. de Brabandt
Bielefeld, Germany
Dr. Werner Göttker-Schnetmann
Frankfurt, Germany
Dr. Deininger
Munich, Germany
Dr. Kränzlin
Munich, Germany
Dr. Kästner
Munich, Germany
Dr. Kühne
Munich, Germany
Bianca Moll-Bosch
Siegen, Germany
Dr. Susanne Feidicker
Steinhagen, Germany
...and 3 more locations
Local tolerability of IMD defined as a cumulative sum score of solicited local ADE for each Patient
Local tolerability of the IMD will be defined as a cumulative sum score of the solicited local (vaginal) ADE (consisting of subjectively experienced symptoms rated by the patient: burning, itching, bleeding, pain, dryness and objectively documented findings rated by the physician: redness, petechial bleeding, dryness, swelling) for each patient after 1 and 3 weeks of application (Visit 3 and Visit 4, respectively).
Time frame: 3 weeks
Subjective symptoms (local tolerability)
Each of the subjective symptoms (scored from 0 \[none/normal\] to 3 \[severe\]) at Visit 2 (before the first application), Visit 3 (after 1 week of application) and Visit 4 (after 3 weeks of application)
Time frame: 3 weeks
Objective findings
Each finding (scored from 0 \[none/normal\] to 3 \[severe\]) as well as each sum score at Visit 3 (after 1 week of application) and Visit 4 (after 3 weeks of application) will be summarised by the maximum value and the mean value for Visit 3 and Visit 4, respectively
Time frame: 3 weeks
Global judgement of tolerability
Global judgement of tolerability by investigator and patient at Visit 4 (after 3 weeks of application)
Time frame: 3 weeks
AE and ADE (Safety)
Unsolicited AEs and ADEs
Time frame: up to 4 months
Occurrence of AE / SAE / ADE / SADE (Serious Adverse Event) (Safety)
Occurrence of AE / SAE / ADE / SADE
Time frame: up to 4 months
Characteristics of AE / SAE / ADE / SADE (Safety)
Characteristics of occured AE / SAE / ADE / SADE
Time frame: up to 4 months
Change in biofilm EPS
Proof of the biofilm EPS at Visit 2 (before the first application), Visit 3 (after 1 week of application), Visit 4 (after 3 weeks of application) and Visit 5 (after Follow-up Phase, i.e.12 weeks after the end of the application Phase (Visit 4)) Combined Parameter: Evaluation of Extracellular Polymeric Substances (EPS) in urine samples and evaluation of existence of bacterial biofilm
Time frame: up to 4 months
Change in pH-value from vaginal smear
pH-value from vaginal smear at visit 2 (before the first application), Visit 3 (after 1 week of application), Visit 4 (after 3 weeks of application) and Visit 5 (after Follow-up Phase, i.e.12 weeks after the end of the application Phase (Visit 4))
Time frame: within 4 months
Change in Nugent-Score
Nugent-Score at Visit 2 (before the first application), Visit 3 (after 1 week of application) and Visit 4 (after 3 weeks of application)
Time frame: within 3 weeks
Change in Vaginal flora
Vaginal flora (Lactobacillus spp., Atopobium vaginae and Gardnerella vaginalis) at Visit 2 (before the first application), Visit 3 (after 1 week of application) Visit 4 (after 3 weeks of application) and Visit 5 (after Follow-up Phase, i.e.12 weeks after the end of the application Phase (Visit 4))
Time frame: within 4 months
Time to recurrence of BV
Time from the end of application (Visit 4) to the first recurrence of BV within the Follow-up Phase of 12 weeks
Time frame: up to 3 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.