Oteseconazole: an advance in treatment of recurrent vulvovaginal candidiasis


This review, recently published in our partner journal Future Microbiology, discusses the pharmacology of oteseconazole and summarizes clinical studies investigating repeat/recurrent vulvovaginal candidiasis (RVVC). RVVC is defined as ≥3 recurrences of symptomatic VVC within a 12-month period, with completely asymptomatic periods between acute VCC episodes. Currently, there is significant unmet clinical need for a more effective treatment for RVVC infection with fewer adverse effects. Oteseconazole is a novel, oral, selective fungal cytochrome P450 enzyme 51 inhibitor, designed to have enhanced potency against a broad spectrum of fungal pathogenic species, including fluconazole-resistant vaginal isolates. The favorable safety data from multiple preclinical and Phase I and II studies, together with a demonstrated reduction in long term VVC recurrence, point to an optimistic future for clinicians and women with RVVC.


Recurrent vulvovaginal candidiasis (RVVC) has significant disease, financial and quality-of-life burdens, affects women from all strata of society worldwide, and lacks an approved therapeutic solution. Fluconazole emerged in 2004 as an antifungal for RVVC; it provides symptom control and has been accepted worldwide as a first-line treatment. Its limitations include development of resistance and a high rate of VVC recurrence after therapy cessation. There is now an improved treatment option on the horizon: oteseconazole—a novel, oral, selective fungal cytochrome P450 enzyme 51 inhibitor, designed to avoid off-target toxicities. In clinical studies to date, oteseconazole has demonstrated impressive efficacy, a positive tolerability profile and hope for a superior RVVC treatment option.


Many women are affected by vaginal fungal infections, also called yeast infections. These infections can affect normal daily activities and have negative emotional and financial effects as well, especially for women who have yeast infections repeatedly. There is no US FDA-approved treatment for repeated yeast infections although the symptoms are often managed with a prescription anti-fungal medication, fluconazole. Using fluconazole can have health risks though, especially when it is used repeatedly over months or years. Another problem is that the yeasts that cause the infection can become resistant to the treatment. However, a new medication has been developed and tested in clinical studies and may soon provide women with an effective treatment option for repeated yeast infections that is also safer.

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