Safety and Efficacy of 5% Monolaurin Vaginal Gel Administered Intravaginally for the Treatment of Bacterial Vaginosis

NCT02709005 | Completed Phase 2 Results FDA Drug

• 2 other identifiers: 12-0021HHSN272201300017I
• Study Type: interventional
• Target: 109
• Locations: 1 country
• Sites: 3

Brief Summary

This is a Phase II, Double-Blind, Randomized, Placebo-Controlled, Multi-center Trial enrolling 120 subjects with Bacterial Vaginosis who will be randomized at a ratio of 2:1 to receive active test article (5% Monolaurin Vaginal Gel) or placebo (vehicle). The primary objective is to assess the safety and tolerability of 5% Monolaurin Vaginal Gel compared to vehicle placebo gel (excipients only) and to assess the efficacy by clinical cure rate of 5% Monolaurin Vaginal Gel compared to vehicle placebo gel at Visit 2.

Conditions

Bacterial Vaginosis

Keywords

Bacterial Vaginosis; Monolaurin Vaginal Gel

Outcome Measures

Primary Outcomes (3)

• Number of Participants With Clinical Cure in Each Study Arm

  A clinical cure was defined by normal Amsel criteria, including: normal physiological vaginal discharge, whiff test negative for any amine "fishy" odor, saline wet mount less than 20% for clue cells, and vaginal pH is \<=4.5. All four criteria had to be normal with none of the clinical failure criteria met to be considered a clinical cure. A clinical failure was defined by at least one of the following: one or more abnormal Amsel criteria, early discontinuation of study therapy due to lack of treatment effect, use of any vaginosis therapy other than study product during the study, or in the investigator's opinion, required additional treatment for vaginosis.

  Visit 2 (Day 8-15)

• Number of Participants Reporting Solicited Urogenital Adverse Events (AEs) Following the First Dose of the Study Product

  Solicited event assessments were captured on a memory aid starting on Day 1, the first day of therapy and continuing for 5 days. The participant recorded the presence and intensity of vulvovaginal solicited events on the memory aid. Any symptom that was present at the time that the participant was screened was considered as baseline and not reported as a solicited urogenital AE. However, if the symptom deteriorated during the reporting period, it was considered an AE. If a symptom was reported that was not present at baseline, it too was considered an AE. Any symptoms still present on Day 5 were followed by participant memory aid notations until symptom resolution. Solicited events collected include vaginal odor, vaginal pain, vaginal tenderness, vaginal itching, vaginal dryness, vaginal discharge, and vaginal inflammation. Severity of solicited events symptoms were graded as mild, moderate, or severe according to the grading table in the protocol.

  Days 1 through 5

• Number of Participants Reporting Serious Adverse Events (SAEs) Considered Product-related

  The number of participants in each treatment group with product-related SAEs was assessed. An AE was considered "serious" if, in the view of either the investigator or sponsor, it resulted in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, or a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, a congenital anomaly/birth defect. Important medical events that may not result in death, be life-threatening, or require hospitalizations could be considered serious when, based upon appropriate medical judgment, they could jeopardize the participant and require medical or surgical intervention to prevent one of the outcomes listed. An AE was considered related if there was a reasonable possibility that the study product caused the AE, meaning that there is evidence to suggest a causal relationship between the study product and the AE.

  Visit 1 (Day 1) through Visit 3 (Day 22-31)

Secondary Outcomes (9)

• Number of Participants With Therapeutic Cure in Each Study Arm

  Visit 2 (Day 8-15)

• Number of Participants With Therapeutic Cure in Each Study Arm

  Visit 3 (Day 22-31)

• Number of Participants With Nugent Score of 3 or Less (Negative for BV) in Each Study Arm

  Visit 2 (Day 8-15)

• Number of Participants With Nugent Score of 3 or Less (Negative for BV) in Each Study Arm

  Visit 3 (Day 22-31)

• Number of Participants With Nugent Score of 4-6 (Intermediate BV) in Each Study Arm

  Visit 2 (Day 8-15)

Study Arms (2)

5% Monolaurin Vaginal Gel

EXPERIMENTAL

80 subjects will receive 5% Monolaurin Gel twice daily for three successive days for a total of 6 doses

Drug: 5% Monolaurin Vaginal Gel

Vehicle Placebo

PLACEBO COMPARATOR

40 subjects will receive placebo Gel twice daily for three successive days for a total of 6 doses

Other: Placebo

Interventions

5% Monolaurin Vaginal Gel DRUG

Monolaurin Vaginal Gel is a clear and colorless, non-sterile glycol-based gel for vaginal administration , and commonly referred to as glycerol monolaurate (GML). Each subject will receive intravaginal gel twice daily for three successive days for a total of 6 doses. There will be 3 clinic visits over 30 days.

5% Monolaurin Vaginal Gel

Placebo OTHER

The placebo gel is a clear to opaque, colorless to light gray, non-sterile glycol-based gel for vaginal administration. The placebo gel contains the same excipients as the Monolaurin vaginal gel. Each subject will receive intravaginal gel twice daily for three successive days for a total of 6 doses. There will be 3 clinic visits over 30 days.

Vehicle Placebo

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Non-pregnant, non-breastfeeding females between the ages of 18 and 50 years, inclusive
• Women of childbearing potential\* must agree to practice reliable contraception\*\* for the 28-day period before enrollment through 30 days following treatment.
• \*(not surgically sterile via tubal ligation, bilateral oophorectomy or hysterectomy, or who have not been postmenopausal for \>/=1 year)
• \*\* Acceptable birth control methods for the purposes of this study may include, but are not limited to, abstinence from intercourse with a male partner, monogamous relationship with vasectomized partner, barrier methods to include condoms and diaphragms, intrauterine devices, and licensed hormonal methods. NuvaRing® contraceptive use will be prohibited from this study since the device can alter vaginal secretions
• Presenting with signs of BV (as per Amsel Criteria). Subjects must meet any three of the four criteria for enrollment\*
• \*Presence of discharge, greater than or equal to 20% clue cells on wet prep, positive "whiff test" on KOH prep, vaginal pH of greater than 4.5
• Not currently menstruating or expected to in the next 4 days
• Able to understand and comply with planned study procedures
• Willing to abstain from sexual intercourse, insertion of tampons, douches, or other intravaginal medications or objects between Visit 1 and Visit 2 and 48 hours prior to Visit 3
• Provide written informed consent before initiation of any study procedures and be available for all study visits
• No known history of HIV

You may not qualify if:

• Signs or symptoms of vaginal/cervical/pelvic infection on screening or clinical diagnosis of vaginal/cervical/pelvic infection in the past 14 days.
• Treatment for BV within the past 14 days
• Cervical or vaginal high grade squamous intraepithelial dysplasia (HSIL), atypical glandular cells of uncertain significance (AGUS) or cervical intraepithelial neoplasia grade 2 (CIN2) or higher\*
• Atypical squamous cells of undetermined significance (ASCUS), low grade squamous intraepithelial lesion (LSIL) or cervical intraepithelial neoplasia grade 1 (CIN1) are acceptable. Individuals with a history of atypical glandular cells of uncertain significance (AGUS), HSIL or CIN2 and who have received subsequent evaluation and/or treatment with follow up normal PAP smear are eligible. Patient report will be accepted
• History of undiagnosed vaginal bleeding
• Use of a systemic, vaginal, or perineal antibiotic within 7 days prior to enrollment in this study
• Use of an immunosuppressive or immunomodulatory drug\* for two or more consecutive weeks within 6 months prior to enrollment
• such as \>0.5 mg/kg/day or \>/=20 mg total dose/day of prednisone orally or \>800 µg of inhaled beclomethasone (nasal and non-genital topical steroids are allowed)
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to Monolaurin Vaginal Gel
• Uncontrolled concurrent illness\*. Subjects with a history of organ or marrow transplant are excluded.
• Including, but not limited to, ongoing or active infection, active liver, kidney or autoimmune diseases (a history of thyroid disease will be permitted as long as the thyroid disease is now stable), symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• Acute illness within 3 days before receipt of study product (per investigator's discretion)
• Pregnant women and women who are planning to become pregnant within 30 days after the final study dose, or women who are breastfeeding
• Immunosuppression as a result of an underlying illness or treatment or use of anticancer chemotherapy or radiation therapy (cytotoxic) within the preceding 36 months
• Active neoplastic disease\* or a history of any hematologic malignancy. Active neoplastic disease is defined as neoplastic disease or treatment for neoplastic disease within the past 5 years

Sponsors & Collaborators

• National Institute of Allergy and Infectious Diseases (NIAID): lead

Study Sites (3)

University of Iowa - Vaccine Research and Education Unit

Iowa City, Iowa, 52242-2600, United States

Location

Duke Human Vaccine Institute - Duke Clinical Vaccine Unit

Durham, North Carolina, 27704, United States

Location

Cincinnati Children's Hospital Medical Center - Infectious Diseases

Cincinnati, Ohio, 45229-3039, United States

Location

MeSH Terms

Conditions

Vaginosis, Bacterial

Condition Hierarchy (Ancestors)

Bacterial Infections; Bacterial Infections and Mycoses; Infections; Vaginitis; Vaginal Diseases; Genital Diseases, Female; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Genital Diseases

Results Point of Contact

• Title: Patricia Winokur, MD
• Organization: University of Iowa Hospitals and Clinics

patricia-winokur@uiowa.edu

319-384-4590

Publication Agreements

• PI is Sponsor Employee: No
• Restriction Type: LTE60
• Restrictive Agreement: Yes

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: NIH
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 10, 2016
• First Posted: March 15, 2016
• Study Start: April 14, 2016
• Primary Completion: December 11, 2017
• Study Completion: December 11, 2017
• Last Updated: December 28, 2018
• Results First Posted: December 28, 2018

Record last verified: 2017-07-19

Locations

US (3)