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October 29, 2021
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Clotrimazole vaginal expansion suppositories noninferior to tablets

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Clotrimazole vaginal expansion suppositories for the treatment of mild and moderate vulvovaginal candidiasis were no less effective than vaginal tablets, according to researchers.

Additionally, patients preferred the suppositories, according to Qiongqiong Zhang, PhD, of Tsinghua University in Beijing, and colleagues, who presented their findings at the ASRM Scientific Congress & Expo.

Zhang Q, et al. Abstract P-348. Presented at: ASRM Scientific Congress & Expo; Oct. 17-20, 2021; Baltimore (hybrid meeting).
Zhang Q, et al. Abstract P-348. Presented at: ASRM Scientific Congress & Expo; Oct. 17-20, 2021; Baltimore (hybrid meeting).

Zhang and colleagues conducted a randomized clinical trial in five hospitals from August 2017 to October 2018, involving 105 patients in an experimental group who applied a clotrimazole vaginal expansion suppository (150 mg) each night for 7 days and 106 patients in a control group who used a single clotrimazole vaginal tablet (500 mg).

The researchers conducted follow-ups with the patients 8 (±3) and 30 (±5) days after patients discontinued treatment to assess clinical symptoms, patient satisfaction, side effects and recurrence rates.

Using fungal cultures, the researchers found during the first follow-up that the experimental group had a cure rate of 66.7% (n = 70) and a total effective rate of 98.1% (n = 103) compared with a 63.2% (n = 67) cure rate and 99.1% (n = 105) total effective rate among the control group, with no statistically significant difference.

During the second follow-up, the experimental and control groups had a 5.7% (n = 4) and 14.9% (n = 10) recurrence rate, respectively, again with no significant difference. Additionally, there was no statistical difference between the groups in terms of side effects, which primarily included vaginal stimulation, itching and burning sensation.

The researchers noted that the experimental group had significantly better satisfaction with their treatment. As the suppository expands, they explained, it prevents leakage of melted medicine and vaginal secretions, reducing discomfort.

The researchers concluded that clotrimazole vaginal expansion suppositories are noninferior to tablets for treating vulvovaginal candidiasis and that they also provide patient satisfaction, improve clinical symptoms and further reduce recurrence, making them an important option for clinical use.