Jack D. Sobel, MD, examines the efficacy and safety of oteseconazole in reducing the incidence of recurrent vulvovaginal candidiasis in patients.
At the 2022 American College of Obstetricians and Gynecologists Annual Clinical & Scientific Meeting in San Diego, California, Jack Sobel, MD, Dean and Distinguished Professor at Wayne State University School of Medicine in Detroit, Michigan, discussed how the condition of recurrent vulvovaginal candidiasis (RVVC), a chronic version of vulvovaginal candidiasis (VVC) affects women; past treatments; and the newly-approved FDA drug, oteseconazole (Vivjoa).
According to the US Centers for Disease Control and Prevention, RVVC is defined as 3 or more symptomatic, acute episodes of yeast infection in a year, affecting up to 9% of women in the United States, with nearly half of women with RVVC aged 45 and older. The condition makes a significant impact on quality of life, including a burden on their mental health, expressing through depression and anxiety. Up until now, current treatment protocols included both prescription and topical OTC azole antifungals (fluconazole, which emerged in 2004) not approved by the FDA. While fluconazole did alleviate symptoms of RVVC, it could not combat recurrence rates.
A new treatment option has emerged. Oteseconazole (Vivjoa), approved by the FDA in April 2022, has been shown to reduce the incidence of RVVC in older women (those who are not of reproductive age). For ob gyns, this is important to note to their patients who are of reproductive age, as oteseconazole can cause fetal harm (ocular toxicities). Oteseconazole has been proven effective against several different candida organisms, including candida albicans, candida glabrata, candida tropicalis, and others. It works by inhibiting fungal CYP51, the element required for fungal wall integrity. It is both more than 2000 times more selective than fluconazole for fungal CYP51 and offers a lower affinity for host theme-iron than other azoles.
Trials to test the safety of oteseconazole and its ability to prevent recurring episodes of RVVC showed an overwhelming majority (roughly 95%) of women receiving oteseconazole did not have a recurrence for almost a year (compared with approximately 60% of patients receiving the placebo.) Additionally, investigators noted, otesconazole was safe and well-tolerated with no notable differences in adverse events between osteseconazole and placebo groups.
Reference
Sobel J. Introducing the first and only medication approved by the FDA to reduce the incidence of recurrent vulvovaginal candidiasis (RVVC). Presented at: 2022 American College of Obstetricians and Gynecologists Annual Clinical & Scientific Meeting. May 6, 2022. San Diego, California.
Rising endometriosis rates linked to increased pregnancy complications
May 19th 2024A new study presented at the 2024 ACOG meeting reveals a significant rise in endometriosis among pregnant women over the past 20 years, linking the condition to increased obstetric and neonatal complications.
Read More
Buprenorphine use in pregnancy linked to decreased fetal breathing movements
May 18th 2024According to a poster presented at ACOG 2024, use of the synthetic opioid buprenorphine depressed fetal breathing in biophysical profile assessments, but had no significant impact on other factors like amniotic fluid index or fetal tone.
Read More
Laparoscopic RFA linked to enhanced pregnancy outcomes in uterine fibroid patients
May 18th 2024A recent study presented at the 2024 ACOG Clinical and Scientific Meeting reveals that laparoscopic radiofrequency ablation significantly improves pregnancy outcomes for women with uterine leiomyomas.
Read More
Identifying gaps in syphilis treatment and prenatal care among pregnant individuals
May 17th 2024Preventing congenital syphilis comes down to quick diagnosis and treatment of the infection in pregnancy, and the number of missed opportunities to do so in the United States continues to grow.
Read More