Optimization of Bacterial Vaginosis Treatment in Women of Reproductive Age

NCT ID: NCT06458543

Last Updated: 2025-04-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-01

Study Completion Date

2026-06-01

Brief Summary

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The purpose of this clinical trial is to study the efficacy of bovgialuronidase azoximere in the treatment and duration of recurrence-free course of bacterial vaginosis in women of reproductive age. The main questions it aims to answer are:

* Is bovgialuronidase azoximer able to destroy G. vaginalis associated biofilms of the vaginal epithelium
* use of bovgialuronidase azoximer together with Metronidazole increases the effectiveness of treatment of bacterial vaginosis.
* use of azoximers bovgialuronidase together with Metronidazole increases the duration of relapse-free course of bacterial vaginosis.

Participants in the experimental and control group will be:

* Amsel criteria assessment
* Colpotest-PH (vaginal acidity)
* aminotest with 10% KOH solution ("fish odor")
* microscopic examination of vaginal discharge
* Bacteriologic culture of vaginal discharge
* Polymerase chain reaction of epithelial cell scrapings from the vagina
* electron microscopy of vaginal epithelial cell scrapings

Participants in the main group will be given the drug Bovgialuronidase azoximer and Metronidazole.

Participants in the control group: Metronidazole.

Researchers will compare the experimental and control groups to see if there are differences after treatment in biofilm structure, treatment efficacy, and duration of recurrence-free survival.

Detailed Description

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Bacterial vaginosis is characterized by a decrease in the number of lactobacilli and the dominance of opportunistic anaerobic flora (primarily G.vaginalis, to a lesser extent Atopobium vaginae, Peptostreptococcus, Clostridiales spp., Prevotella spp., etc.). Modern ideas of the pathogenesis of bacterial vaginosis consist in the formation of polymicrobial biofilms on the surface of the mucosa of the vaginal epithelium. Biofilms are a community of microorganisms of one or more species attached to the surface of a polymeric matrix. Biofilms are formed predominantly by G.vaginalis and to a lesser extent by other pathogens associated with bacterial vaginosis (Atopobium vaginae, Peptostreptococcus, Clostridiales spp., Prevotella spp., etc.). Biofilm-associated bacterial vaginosis is characterized by increased resistance to pathogenetic therapy, the ability to evade defense mechanisms and prolonged persistence in the vaginal environment. These features of pathogenesis cause a high rate of recurrences and chronic course of bacterial vaginosis.

Thus, it is relevant to study in vivo the role of drug action on biofilms to destroy them in order to increase the effectiveness of antibacterial therapy and reduce the frequency of recurrences of bacterial vaginosis.

The standard and approved by the Ministry of Health of the Russian Federation method of treatment of bacterial vaginosis is Metronidazole.

The aim of this clinical trial is to investigate the efficacy of combination therapy with metronidazole and azoximera bovgialuronidase in the treatment and duration of relapse-free course of bacterial vaginosis in women of reproductive age compared with metronidazole monotherapy.

The main questions it aims to answer are:

* Is bovgialuronidase azoximer able to destroy G. vaginalis associated biofilms of the vaginal epithelium
* use of bovgialuronidase azoximer together with Metronidazole increases the effectiveness of treatment of bacterial vaginosis.
* use of azoximers bovgialuronidase together with Metronidazole increases the duration of relapse-free course of bacterial vaginosis.

Participants in the experimental and control group will be:

* Amsel criteria assessment
* Colpotest-PH (vaginal acidity)
* aminotest with 10% KOH solution ("fish odor")
* microscopic examination of vaginal discharge
* Bacteriologic culture of vaginal discharge
* Polymerase chain reaction of epithelial cell scrapings from the vagina
* electron microscopy of vaginal epithelial cell scrapings

Main group - patients with bacterial vaginosis receiving pathogenetic antibacterial therapy (Metronidazole) in combination with Bovgialuronidase azoximer.

Control group - patients with bacterial vaginosis receiving pathogenetic antibacterial therapy (Metronidazole) without Bovgialuronidase azoximer.

Researchers will compare the experimental and control groups to see if there are differences after treatment in biofilm structure, treatment efficacy, and duration of recurrence-free survival.

Conditions

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Bacterial Vaginosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Experimental

The experimental group includes 50 women of reproductive age (18 - 45 years old) with an established diagnosis of bacterial vaginosis.

Participants in the experimental group will be given the drug Bovgialuronidase azoximer and Metronidazole.

Bovhyaluronidase azoximer, vaginal suppositories 3000 IU, 1 suppository vaginally every other day, course of 10 days Metronidazole, tablets 500 mg, 1 tablet 2 times a day, orally, course 7 days

Group Type EXPERIMENTAL

Longidaza

Intervention Type DRUG

Bovhyaluronidase azoximer, vaginal suppositories 3000 IU, 1 suppository vaginally every other day, course of 10 days

Metronidazole 500 mg

Intervention Type DRUG

Metronidazole, tablets 500 mg, 1 tablet 2 times a day, orally, course 7 days

Control

The control group includes 50 women of reproductive age (18 - 45 years old) with an established diagnosis of bacterial vaginosis.

Metronidazole, tablets 500 mg, 1 tablet 2 times a day, orally, course 7 days

Group Type ACTIVE_COMPARATOR

Metronidazole 500 mg

Intervention Type DRUG

Metronidazole, tablets 500 mg, 1 tablet 2 times a day, orally, course 7 days

Interventions

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Longidaza

Bovhyaluronidase azoximer, vaginal suppositories 3000 IU, 1 suppository vaginally every other day, course of 10 days

Intervention Type DRUG

Metronidazole 500 mg

Metronidazole, tablets 500 mg, 1 tablet 2 times a day, orally, course 7 days

Intervention Type DRUG

Other Intervention Names

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Bovhyaluronidase azoximer Metronidazol

Eligibility Criteria

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Inclusion Criteria

* The written informed consent of the patient to participate in the study;
* Age (18 - 45 years old);
* The established diagnosis of Bacterial vaginosis;
* Absence of pregnancy and lactation.

Exclusion Criteria

* Refusal of the patient from further participation in the study;
* Lack of patient adherence to treatment;
* The occurrence of conditions and diseases related to the list of contraindications to the use of the studied drug during the study.
* The presence of Neisseria gonorrhoeae, Trichomonas vaginalis, confirmed by laboratory;
* The presence of contraindications to the use of the studied drug according to the instructions for the drug.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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I.M. Sechenov First Moscow State Medical University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Leonid Spivak, MD,Prof.

Role: PRINCIPAL_INVESTIGATOR

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Kseniya Rossolovskaya

Role: STUDY_DIRECTOR

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Locations

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LLC "Family polyclinic No. 4" Korolev

Korolyov, , Russia

Site Status RECRUITING

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Moscow, , Russia

Site Status RECRUITING

Countries

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Russia

Central Contacts

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Leonid Spivak, MD, Prof.

Role: CONTACT

+7 (903) 749-05-97

Facility Contacts

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Leonid Spivak, MD, Prof.

Role: primary

+7 (903) 749-05-97

Kseniya Rossolovskaya

Role: backup

+7 (980) 164-77-99

Leonid Spivak, MD, Prof.

Role: primary

+7 (903) 749-05-97

Kseniya Rossolovskaya

Role: backup

+7 (980) 164-77-99

Other Identifiers

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Longidaza IMSechenovMMA

Identifier Type: -

Identifier Source: org_study_id

NCT06453200

Identifier Type: -

Identifier Source: nct_alias

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