Vandecruys Paul, Baldewijns Silke, Sillen Mart, Van Genechten Wouter, Van Dijck Patrick
Laboratory of Molecular Cell Biology, Department of Biology, Katholieke Universiteit Leuven, Leuven, Belgium.
Expert Rev Anti Infect Ther. 2023 Jul-Dec;21(8):799-812. doi: 10.1080/14787210.2023.2233696. Epub 2023 Jul 24.
Recurrent vulvovaginal candidiasis (RVVC) affects women worldwide and has far-reaching implications for a patient's quality of life. For decades, maintenance treatment using the azole antifungal fluconazole was the preferred treatment. Although efficient in controlling the symptoms, the development of azole resistance and high rates of recurrence after therapy cessation have emerged as significant limitations. Nevertheless, persistent efforts have delivered novel treatment options. Oteseconazole (VT-1161), marketed as VIVJOA, is an oral, tetrazole antifungal with unprecedented specificity toward the fungal lanosterol 14α-demethylase.
We reviewed literature data on oteseconazole with a focus on the management of RVVC.
Therapeutic options for RVVC are limited, and novel, innovative approaches are needed to treat this debilitating condition. These therapies need to be well-tolerated and prevent RVVC recurrence. The available clinical data show excellent safety and efficacy, with an unprecedentedly low recurrence rate. However, we believe health-care providers should be mindful to monitor for the development of resistance, as this may result in treatment failure. Further, the availability and cost may, like for most novel drugs, affect the widespread clinical implementation of VIVJOA. Altogether, we are convinced that VIVJOA is a significant advance in RVVC management.
复发性外阴阴道念珠菌病（RVVC）影响着全球女性，对患者的生活质量有着深远影响。几十年来，使用唑类抗真菌药氟康唑进行维持治疗一直是首选治疗方法。尽管在控制症状方面有效，但唑类耐药性的出现以及治疗停止后高复发率已成为显著限制。然而，持续的努力带来了新的治疗选择。奥替康唑（VT - 1161），商品名为VIVJOA，是一种口服的四唑类抗真菌药，对真菌羊毛甾醇14α - 脱甲基酶具有前所未有的特异性。
我们回顾了关于奥替康唑的文献数据，重点是RVVC的管理。
RVVC的治疗选择有限，需要新颖、创新的方法来治疗这种使人衰弱的疾病。这些疗法需要耐受性良好并预防RVVC复发。现有的临床数据显示出极佳的安全性和有效性，复发率空前低。然而，我们认为医疗保健提供者应注意监测耐药性的发展，因为这可能导致治疗失败。此外，与大多数新药一样，可及性和成本可能会影响VIVJOA在临床上的广泛应用。总体而言，我们确信VIVJOA是RVVC管理方面的一项重大进展。
