IRCCS-Ospedale San Martino, Clinica Ostetrica e Ginecologica, Departmet of Neuroscience, Rehabilitation Ophthalmology, Genetic and Sciences of the Mother and the Infant, Genoa, Italy.
Opera CRO, a TIGERMED Group Company, Timișoara, România.
Eur J Obstet Gynecol Reprod Biol. 2022 Mar;270:239-245. doi: 10.1016/j.ejogrb.2022.01.021. Epub 2022 Feb 1.
During menopausal transition, women are frequently affected by vulvovaginal atrophy (VVA), due to the decline of estrogen levels. Resulting symptoms are itching, burning, dyspareunia, and vaginal dryness (reported in up to 85%). The aim of this trial was to verify if medical device polycarbophil vaginal (PCV) moisturizer gel is not less effective than hyaluronic acid (HA) gel in treating vaginal dryness.
This was a multicenter, open label, randomized, parallel group, comparative study with non-inferiority design. Female included were ≥45 to ≤55 years in the menopausal transition, with subjective dryness, any objective sign of VVA, pH > 5, and body mass index of ≥18.5 to ≤36 kg/m. Subjects were randomized to 1 g of PCV gel twice a week for 30 days or 3 g of HA vaginal gel every 3 days for 30 days.
53 subjects (mean age 49.45 ± 2.96 years) were analyzed. Vaginal health index showed an improvement (p < 0.001) in both groups (from 12.54 ± 1.37 to 16.36 ± 2.66 for PCV, from 12.00 ± 1.91 to 16.60 ± 2.50 for HA), but the difference between final means (95%CI: -1.66 to 1.18) evidenced that PCV is non-inferior to HA treatment. Similarly, an improvement was evidenced in vaginal maturation index (p = 0.005 for PCV, ns. for HA), female sexual function index (p < 0.001 for PCV, p < 0.001 for HA), and SF-12 (p < 0.001 for PCV, p < 0.001 for HA), with no difference between groups. Safety was optimal and no adverse events were reported.
The use of HA gel does not give additional benefits to those that are already provided by the moisturizing PCV.
在绝经过渡期,由于雌激素水平下降,女性经常受到外阴阴道萎缩(VVA)的影响。由此产生的症状有瘙痒、灼热、性交困难和阴道干燥(高达 85%的女性报告有此症状)。本试验旨在验证聚卡波非阴道(PCV)保湿凝胶在治疗阴道干燥方面是否不比透明质酸(HA)凝胶更有效。
这是一项多中心、开放性标签、随机、平行组、非劣效性设计的比较研究。纳入的女性年龄在 45 岁至 55 岁之间,处于绝经过渡期,有主观干燥感,任何 VVA 的客观体征,pH 值>5,体重指数≥18.5 至≤36kg/m。受试者被随机分为每周两次使用 1g PCV 凝胶,共 30 天,或每三天使用 3g HA 阴道凝胶,共 30 天。
共分析了 53 名受试者(平均年龄 49.45±2.96 岁)。两组的阴道健康指数均有改善(p<0.001)(PCV 组从 12.54±1.37 增加到 16.36±2.66,HA 组从 12.00±1.91 增加到 16.60±2.50),但最终均值的差异(95%CI:-1.66 至 1.18)表明 PCV 与 HA 治疗无差异。同样,阴道成熟指数(PCV 为 p=0.005,HA 为 ns.)、女性性功能指数(PCV 为 p<0.001,HA 为 p<0.001)和 SF-12(PCV 为 p<0.001,HA 为 p<0.001)也有改善,两组之间无差异。安全性最佳,未报告不良事件。
使用 HA 凝胶并不能为已经由保湿 PCV 提供的治疗带来额外的益处。