Safety and Efficacy of Boric Acid Inserts for Treatment of Vulvovaginal Candidiasis

NCT ID: NCT07109869

Last Updated: 2025-12-24

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

PHASE3

Total Enrollment

201 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-08

Study Completion Date

2026-06-30

Brief Summary

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This is a Phase 3 clinical study to evaluate the efficacy, safety, and tolerability of boric acid 600 mg vaginal inserts in patients with VVC.

Detailed Description

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This clinical study will be a multi-center, randomized, placebo-controlled, double-blinded study with a 3-arm design comparing 600 mg boric acid vaginal inserts dosed for 7 or 14 days to placebo. All patients will self-administer vaginal inserts once daily for 14 days.

During self-administration of the study drug, patients will be instructed to utilize an electronic diary (eDiary) to record their daily symptoms from Screening through Day 28 (Visit 5). The following information will be recorded in the eDiary:

* Study drug administration (including time at which study drug was administered, activity following study drug administration, and whether the bladder was emptied prior to administration);
* Vulvovaginal symptoms;
* Any adverse symptoms or symptoms of concern, illnesses, or physical injuries that occur while participating in the clinical study;
* Contraceptive methods utilized;
* Days of menstrual bleeding, including days of heavy menstrual bleeding (defined as "flooding" or bleeding through ≥1 tampon or sanitary pad in 2 hours or less), start date of menstrual cycle, end date of menstrual cycle, and daily quantity of menstrual hygiene product(s) utilized for each day of menses;
* Position (eg, laying down supine, prone, on side) following study drug administration;
* Vulvovaginal sexual activity, including if the sexual activity occurred before or after study drug administration; and
* The presence of any non-exclusionary intravaginal foreign objects (ie, contraceptive vaginal ring, diaphragm, cervical cap, condom, sex toys).

Patients will complete a total of 4 in-person visits at Screening, on Day 7 (Visit 2) (±2 days), Day 15 (Visit 3) (+2 days), and Day 28 (Visit 5) (±2 days), as well as a telephone Follow-Up Visit on Day 21 (Visit 4) (±2 days) (if clinically indicated, the Follow-Up Visit may be performed in-person).

Clinical, mycological, and overall outcomes will be assessed at Day 15 (Visit 3) and Day 28 (Visit 5) for all study arms. If persistent symptoms are present at any visit, a full microbiologic evaluation to assess for persistence of VVC (including KOH wet mount, saline wet mount, and vaginal fungal culture) will be performed. Additionally, screening tests required to rule out other potential causes of symptoms may be performed or repeated at PI or qualified designee discretion. Patients may also be provided with a rescue treatment at PI or qualified designee discretion.

Individual patient participation is expected to be 28 days.

Conditions

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Vulvovaginal Candidiases Vulvovaginal Candidiasis, Genital Vulvovaginal Candidiasis (VVC)

Keywords

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Vulvovaginal Candidiases VVC

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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7 days 600 mg boric acid inserts followed by 7 days placebo inserts

All patients will self-administer 600 mg boric acid vaginal inserts once daily for first 7 days and placebo vaginal inserts for following 7 days.

Group Type EXPERIMENTAL

Boric acid

Intervention Type DRUG

Boric acid vaginal inserts consisting of 600 mg boric acid drug substance filled into white, opaque hypromellose capsules with no additional excipients included in the formulation. Each vaginal insert is sealed into a clear blister cavity.

Placebo

Intervention Type OTHER

Placebo vaginal inserts containing anhydrous lactose and 1% magnesium stearate are also manufactured and filled into white, opaque hypromellose capsules. Packaged in clear blisters.

14 days placebo inserts

All patients will self-administer placebo vaginal inserts once daily for 14 days.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Placebo vaginal inserts containing anhydrous lactose and 1% magnesium stearate are also manufactured and filled into white, opaque hypromellose capsules. Packaged in clear blisters.

14 days 600 mg boric acid inserts

All patients will self-administer 600 mg boric acid vaginal inserts once daily for 14 days.

Group Type EXPERIMENTAL

Boric acid

Intervention Type DRUG

Boric acid vaginal inserts consisting of 600 mg boric acid drug substance filled into white, opaque hypromellose capsules with no additional excipients included in the formulation. Each vaginal insert is sealed into a clear blister cavity.

Interventions

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Boric acid

Boric acid vaginal inserts consisting of 600 mg boric acid drug substance filled into white, opaque hypromellose capsules with no additional excipients included in the formulation. Each vaginal insert is sealed into a clear blister cavity.

Intervention Type DRUG

Placebo

Placebo vaginal inserts containing anhydrous lactose and 1% magnesium stearate are also manufactured and filled into white, opaque hypromellose capsules. Packaged in clear blisters.

Intervention Type OTHER

Other Intervention Names

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Orthoboric acid Hydrogen orthoborate Trihydroxidoboron

Eligibility Criteria

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Inclusion Criteria

1. Patients who are postmenarcheal, nonpregnant biological females, 12 years of age and older, at Screening;
2. Patients with acute symptomatic VVC infection at Screening, defined as meeting all of the following criteria:

* A potassium hydroxide (KOH) wet mount or saline wet mount preparation performed from the inflamed vaginal mucosa or secretions demonstrating yeast forms (hyphae or pseudohyphae) of or budding yeast;
* Vaginal pH ≤4.5; and
* Total Vulvar Signs and Symptoms (VSS) Scale score of ≥4: vulvovaginal signs (edema, erythema, and excoriation/fissures) and symptoms (vulvovaginal burning, itching, and irritation) as rated using the VSS Scale.
3. Patients aged 21 and older must have cervical cancer screening results meeting the following criteria for inclusion at Screening or within the 1 year prior to Screening: negative for intraepithelial lesion or malignancy or clinically insignificant findings not requiring any further surveillance or treatment beyond a repeat cervical cytology test;

* Patients between 21 and 29 years of age must have a cervical cancer screening test (Papanicolaou \[Pap\] smear) performed at Screening or have a documented Pap smear result within 1 year of Screening which must be available for the assessment by the PI or qualified designee at the Screening Visit; and
* Patients 30 years of age and older must have documented cervical cancer screening tests (Pap smear and high-risk human papillomavirus \[HPV\]) performed at Screening or have documented results within 1 year of Screening which must be available for the assessment by the PI or qualified designee at the Screening Visit.
4. Patients must be suitable candidates for vaginal treatment, able to insert the study drug, and are comfortable undergoing pelvic exams;
5. Patients willing and able to provide written informed consent or assent (for those 12 to 17 years of age);
6. Patients willing and able to comply with Protocol requirements, instructions, and Protocol-stated restrictions, as determined by the PI;
7. Patients willing and able to give authorization for use of protected health information;
8. Patients of childbearing potential (as defined in Inclusion Criterion 1) must use 1 of the following contraceptive options described below through Day 28 (Visit 5):

* Copper intrauterine device used continuously and successfully for at least 90 days prior to the first dose of study drug;
* Levonorgestrel-releasing intrauterine system used successfully for at least 90 days prior to the first dose of study drug;
* Progestin implant used successfully for at least 90 days prior to the first dose of study drug;
* Monogamy with a vasectomized male partner (medical assessment of the surgical success of the vasectomy must have occurred at least 6 months prior to the first dose of study drug);
* Abstinence; or
* Use of 1 of the following hormonal methods in combination with 1 of the following barrier methods:

* Hormonal methods
* Barrier methods
9. Patients must be willing to avoid tampon or menstrual cup use during the Treatment Period (ie, Day 1 to Day 14); and
10. Patients must be willing to abstain from receiving oral intercourse during the Treatment Period (ie, Day 1 to Day 14).

Exclusion Criteria

1. Patients with known or suspected other active infectious causes of cervicitis, vaginitis, or vulvitis (eg, BV, Chlamydia trachomatis, Neisseria gonorrhoeae, T. vaginalis, or genital lesions consistent with HPV, herpes simplex, syphilis, chancroid, etc) based on the results of clinical assessments, in-clinic microscopic assessments (eg, clue cells or trichomonads detected on saline wet mount), and/or rapid diagnostic tests (RDTs) performed prior to enrollment (eg, OSOM® test, etc);
2. Patients who have undergone any vaginal rejuvenation procedure (ie, laser) within 4 weeks prior to Screening or plan to undergo a vaginal rejuvenation procedure prior to completion of the last planned assessment;
3. Patients who will undergo evaluation or treatment during the clinical study for abnormal cytology or findings from high-risk HPV testing or Pap test finding;
4. Patients diagnosed with BV, determined by meeting 3 of the 4 Amsel's criteria:

* A fishy odor of the vaginal discharge before or after the addition of a drop of 10% KOH (ie, a positive whiff test);
* Homogenous, thin discharge (milk-like consistency) that smoothly coats the vaginal walls;
* At least 20% of epithelial cells are clue cells (eg, vaginal epithelial cells studded with adherent bacteria) on saline wet mount microscopic evaluation of vaginal discharge; or
* pH of vaginal fluid \>4.5.
5. Patients currently undergoing treatment for or with a history of treatment for cervical, vaginal, or vulvar cancer;
6. Patients using any systemic (eg, oral or injectable) corticosteroid treatment during the study or within 30 days prior to Screening;
7. Patients using topical steroids applied to the vulvar or vaginal regions during the study or within 7 days prior to Screening;
8. Patients using any systemic (eg, oral or injectable) or topical (applied to the vulvar or vaginal regions) antimicrobials including antifungal, antiviral, antibacterial, or anti-trichomonal drugs during the clinical study or within 14 days prior to Screening;
9. Patients using any prescription (eg, vaginal estrogen, ospemifene, prasterone) or non-prescription intravaginal or vulvar product (eg, vitamin E gel capsules \[vaginal inserts\], lubricants, moisturizers, douches, creams, or spermicides) within 7 days prior to Screening and through Day 28 (Visit 5);
10. Patients unwilling to refrain from the use of intravaginal products (eg, douches, creams, spermicides, yoni eggs, tampons, menstrual cups, and any other such intravaginal product that, in the opinion of the PI, would be considered exclusionary) during the Treatment Period, inclusive of Day 14;
11. Patients with a current immunocompromising condition (ie, HIV, end-stage renal disease);
12. Patients using any immunosuppressive medication (included, but not limited to, carbamazepine, cyclosporine, tacrolimus, methotrexate, 6 mercaptopurine, or mycophenolate) or radiation treatment within 3 months prior to Screening or during the clinical study;
13. Patients with a history of pelvic radiation treatment;
14. Patients with a clinically significant major organ disease, cancer, infection (except acute VVC), or other condition that may affect the clinical assessment of VVC or render the patient a poor study candidate, per the PI's judgment;
15. Patients with any comorbid condition that would preclude the safe participation of the patient in the clinical study or would prevent the patient from meeting the clinical study requirements, per the PI's judgment;
16. Patients with diabetes mellitus type I, use of insulin (current or anticipated need during the study), or poorly-controlled diabetes mellitus type II, defined as (hemoglobin A1c \[(HbA1c\]) of 10% or higher result within the prior 6 months) or at Screening;
17. Patients with any laboratory abnormality that, in the opinion of the PI, would likely introduce additional risk to the patient or might interfere with data interpretation. The findings noted below are particularly exclusionary:

* Serum alanine aminotransferase ≥2.5 × the upper limit of normal (ULN) of the reference range;
* Serum aspartate aminotransferase ≥2.5 × the ULN of the reference range; or
* Serum total bilirubin ≥2 × the ULN of the reference range, unless the elevation is consistent with Gilbert's syndrome
18. Patients with a known history of HIV, hepatitis B, or hepatitis C virus (HCV), or a positive test for HIV antibody, hepatitis B surface antigen, or HCV antibody;
19. Patients who are pregnant (ie, a positive pregnancy test at Screening), lactating, or planning to become pregnant during the clinical study period;
20. Patients with a planned surgery or other medical procedure that would impact compliance with the Protocol, per the PI's discretion;
21. Patients with a current or recent history (eg, the past 12 months) of substance abuse (including alcohol) or any other medical, psychiatric, or other condition that, in the PI's opinion, would preclude compliance with the Protocol;
22. Patients currently participating or had participated in another clinical study within the 30 days prior to Screening;
23. Patients currently have or expect, within the Treatment Period, to have heavy menstrual bleeding (defined as "flooding" or bleeding through ≥1 tampon or sanitary pad in 2 hours or less with most periods) or a menstrual duration \>7 days; or
24. Patients currently have or suspect to have an active urinary tract infection (UTI) based on urinalysis and clinical assessment.
Minimum Eligible Age

12 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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pH-D Feminine Health LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Trial Manager

Role: STUDY_CHAIR

Medpace GmbH

Locations

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Alliance for Multispecialty Research - Mobile

Mobile, Alabama, United States

Site Status RECRUITING

Abby's Research Institute

Phoenix, Arizona, United States

Site Status WITHDRAWN

Century Research Institute, Inc

Huntington Park, California, United States

Site Status RECRUITING

Matrix Clinical Research

Los Angeles, California, United States

Site Status RECRUITING

Project 4 Research Inc

Miami, Florida, United States

Site Status RECRUITING

Entrust Clinical Research

Miami, Florida, United States

Site Status RECRUITING

Felicidad Medical Research, LLC

Miami, Florida, United States

Site Status RECRUITING

Better Life Clinical Research, LLC

Tampa, Florida, United States

Site Status RECRUITING

Helping Hands Health Center

Tampa, Florida, United States

Site Status RECRUITING

Leavitt Clinical Research

Idaho Falls, Idaho, United States

Site Status RECRUITING

Clinical Trials Management, LLC - Northshore

Covington, Louisiana, United States

Site Status RECRUITING

Praetorian Pharmaceutical Research

Marrero, Louisiana, United States

Site Status RECRUITING

Revive Research Institute, Inc.

Dearborn Heights, Michigan, United States

Site Status RECRUITING

Cross Creek Medical Clinic, PA

Fayetteville, North Carolina, United States

Site Status RECRUITING

Unified Women's Clinical Research - Raleigh

Raleigh, North Carolina, United States

Site Status RECRUITING

Unified Women's Clinical Research - Lyndhurst Clinical Research

Winston-Salem, North Carolina, United States

Site Status RECRUITING

Nexgen Research

Lima, Ohio, United States

Site Status RECRUITING

Jackson Clinic

Jackson, Tennessee, United States

Site Status RECRUITING

TMC Life Research, Inc

Houston, Texas, United States

Site Status RECRUITING

National Clinical Trials - VA

Reston, Virginia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Clinical Trial Manager

Role: CONTACT

Phone: 513-709-4442

Email: [email protected]

Facility Contacts

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Clinical Trial Manager

Role: primary

Clinical Trial Manager

Role: primary

Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

Role: primary

Clinical Trial Manager

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Clinical Trial Manager

Role: primary

Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

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Clinical Trial Manager

Role: primary

Other Identifiers

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PHD-CLIN-BOR302

Identifier Type: -

Identifier Source: org_study_id