Use of vitamin C tablet in the prophylaxis of bacterial vaginosis relapses

ISRCTN ISRCTN77890633
DOI https://doi.org/10.1186/ISRCTN77890633
Secondary identifying numbers PM0316
Submission date
11/10/2012
Registration date
24/10/2012
Last edited
24/10/2012
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Infections and Infestations
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English Summary

Background and study aims?
Bacterial vaginosis (BV) is a common condition that affects almost one third of childbearing age women. The cause of BV is still unclear, but currently it is considered to be characterized by depletion of Lactobacillus spp. and an intense increase of vaginal anaerobic bacteria leading to a replacement of Lactobacilli and an increase in vaginal pH. The study aimed to evaluate the potential effect of vitamin C in preventing BV relapses in patients previously cured after a BV episode.

Who can participate?
Out-patient women, aged between 18 and 50 years, with recurrent bacterial vaginosis (BV).

What does the study involve?
Participants were randomly allocated to receive either vitamin C or placebo. Women were instructed to insert the tablets deeply into the vagina at bedtime and were supplied with 250mg vitamin C (ascorbic acid) tablets or a matching placebo (dummy).

What are the possible benefits and risks of participating?
Benefits of participating in the study was maintaining a normal vaginal acidity. No particular risks were foreseen if taking part in the study, however participants my feel some discomfort at the application site like burning and/or itching.

Where is the study run from?
From nine European sites, in Italy (Pavia, Palermo, Lavagna – Genova), Germany (Freiburg), Russia (Moscow), Ukraine (Donezk), Portugal (Porto) and The Netherlands (Dordrecht).

When is study starting and how long is it expected to run for?
The study was carried out between April 2005 and September 2008.

Who is funding the study?
Polichem SA, Lugano, Switzerland

Who is the main contact?
Dr Paola Magnani
paola.magnani@polichem.com

Contact information

Prof Luigi Alio
Scientific

Libero
Obstetrics and Gynaecology
Ospedale Civico e Benfratelli
Palermo
90100
Italy

Study information

Study designMulticenter randomized double-blind placebo controlled parallel group study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typePrevention
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleA randomized, comparative, double-blind, placebo-controlled, parallel group study to evaluate the efficacy of a 250 mg Vitamin C vaginal tablet - as prophylaxis of recurrent bacterial vaginosis
Study hypothesisTo evaluate the effect of vitamin C 250 mg vaginal tablets in comparison to placebo on bacterial vaginosis relapses occuring during the 6-cycle period of prophylaxis in women with a previous episode of bacterial vaginosisv (BV) cured with either metronidazole or clindamycin accoridng to the local therapeutic protocols.
Ethics approval(s)Comitato di Bioetica –Azienda di Rilievo Nazionale e di Alta Specializzazione Ospedale Civico e Benfratelli - Palermo - Italy
Comitato Etico Regione Liguria –Azienda sanitaria locale N.4 “Chiavarese” – Chiavari (GE) –Italy
Comitato di Bioetica - I.R.C.C.S. Policlinico S. Matteo - Pavia – Italy
Lokale Toetsingcommissie - Albert Schweitzer Ziekenhuis, lok. Amstelwijk – Dordrecht – The Netherlands
Ministry of Health of Ukraine -Donetsk State Medical University M. Gorky - Donetsk - Ukraine
Ethics committee at Federal Drug Quality Control - Moscow -Russia
Ethik Kommission der Albert-Ludwigs Universität – Freiburg - Germany
Comissão de Etica da Maternidade de Julio Dinis - Porto - Portugal
ConditionProphylaxis of bacterial vaginosis
InterventionWomen, cured (confirmed by the absence of 3 out of 4 Amsel criteria) from an episode of BV by an antibiotic treatment course of either metronidazole or clindamycin, were randomly assigned to receive vitamin C 250 mg vaginal tablets or placebo as prophylaxis for 6 monthly cycles, starting within 24 hours from the determination of “BV cure”. The patients applied 1 vaginal tablet once a day for 6 consecutive days per month after menses.
Intervention typeOther
Primary outcome measureTime to the first BV relapse (according to Amsel criteria) in the 2 groups during the period of prophylaxis.
Secondary outcome measures1. Vaginal signs and symptoms (Erythema, Oedema, Fissures, Odour, Itching, Burning, Dysuria, Discharge) assessed by means of a four-point scale: 1=absent; 2=mild; 3=moderate; 4=severe
2. Measurement of vaginal pH
3. Investigator’s and subject’s judgement on product acceptability and tolerability assessed by means of a four-point scale: 1= very good, 2= good, 3=fair, 4= poor, 5= very poor
4. Assessment of adverse event (AEs) occurring at any time during the study
Overall study start date02/04/2005
Overall study end date01/09/2008

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexFemale
Target number of participants142
Participant inclusion criteria1. Age ≥ 18 years and < 50 years
2. Medical history positive for recurrent BV episodes (≥ 2 by years)
3. Regular menses
4. Diagnosis of BV (≥ 3 out of 4 Amsel criteria) at enrolment
5. Cure from the current BV episode (≤ 3 out of 4 Amsel criteria) with either metronidazole or clindamycin, according to the local therapeutic protocols
6. Written informed consent
7. Co-operative and reliable women
Participant exclusion criteria1. Subjects with known hypersensitivity to ascorbic acid or to any of the ingredients
2. Metrorrhagia, polymenorrhea, amenorrea
3. Current or previous infections due to Neisseria gonorrheae, Treponema palidum, Herpes genitalis during the last 2 weeks before enrolment
4. Current or previous infections due to Candida spp. or to Trichomonas vaginalis during the last 2 weeks before enrolment
5. Concomitant treatment with local antibiotics, such as metronidazole and clindamycin, during the study prophylaxis
6. Concomitant use of local acidifying agents, disinfectants, Lactobacillus preparations or vaginal douching during the last 2 weeks before enrolment and during the study period
7. Immunodepression, including HIV positive patients
8. Concomitant neoplastic diseases under treatment
9. Ongoing pregnancy of women willing to be pregnant during the study period
10. Participation to clinical trials with investigational drug / devices during the last 3 months before enrolment
11. History of alcohol and drug abuse
12. Subjects likely to be not compliant or uncooperative
Recruitment start date02/04/2005
Recruitment end date01/09/2008

Locations

Countries of recruitment

  • Germany
  • Italy
  • Netherlands
  • Portugal
  • Russian Federation
  • Ukraine

Study participating centre

Libero
Palermo
90100
Italy

Sponsor information

Polichem SA (Switzerland)
Industry

c/o Renata Palmieri
Lugano
6912
Switzerland

Website http://www.polichem.com/
ROR logo "ROR" https://ror.org/05735qy63

Funders

Funder type

Industry

Polichem SA (Swizerland)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan