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关于亚精胺-透明质酸凝胶作为治疗前庭性疼痛的新型治疗策略的临床证据。

Clinical Evidence Regarding Spermidine-Hyaluronate Gel as a Novel Therapeutic Strategy in Vestibulodynia Management.

作者信息

Murina Filippo, Graziottin Alessandra, Toni Nicla, Schettino Maria Teresa, Bello Luca, Marchi Alessandra, Del Bravo Barbara, Gambini Dania, Tiranini Lara, Nappi Rossella Elena

机构信息

Lower Genital Tract Disease Unit, V. Buzzi Hospital, University of the Study of Milan, 20122 Milan, Italy.

Centre of Gynaecology and Medical Sexology, Department of Obstetrics and Gynaecology, San Raffaele Resnati Hospital, 20097 Milan, Italy.

出版信息

Pharmaceutics. 2024 Nov 12;16(11):1448. doi: 10.3390/pharmaceutics16111448.

Abstract

Vestibulodynia (VBD) represents a summation and overlapping of trigger factors (infections, hormonal disturbances, allergies, genetic aspects, psychological vulnerability, and others) with broad individual variability. As there are no standard treatment options for VBD, the disease is still in need of appropriate therapeutic tools. : A prospective observational trial was performed to confirm the efficacy of a topical gel containing a spermidine-hyaluronate complex (UBIGEL donna™) as either a stand-alone or companion treatment through a multicenter study on a large sample population. : For women with VBD (n = 154), the treatment consisted of approximately two months (4 + 4 weeks) of applications according to the posology of UBIGEL. Evaluation of symptoms was performed on relevant clinical endpoints: dyspareunia and vulvovaginal pain/burning by a visual scale (VAS); vestibular trophism by a vestibular trophic health (VeTH) score; vulvoscopy through a cotton swab test; and the level of hypertonic pelvic floor by a physical graded assessment of levator ani hypertonus. : A total of 154 patients treated with UBIGEL donna™ showed significant improvements across all five evaluated parameters, including pain, dyspareunia, swab test results, muscle hypertonicity, and vestibular trophism. Pain and dyspareunia scores decreased by 46.5% and 33.5%, respectively, while significant improvements were also observed in the other parameters ( < 0.0001). These improvements were consistent across various stratifications, including age and disease duration. : The findings of the present study suggest that UBIGEL donna™ is effective in alleviating pain and dyspareunia, as well as reducing vestibular hypersensitivity in women with VBD. Although UBIGEL donna™ alone cannot serve as a comprehensive substitute for all recommended therapies, we suggest that multimodal therapy strategies may be crucial for attaining substantial improvement in any aspect of the condition.

摘要

前庭痛(VBD)代表触发因素(感染、激素紊乱、过敏、遗传因素、心理易感性等)的总和与重叠,个体差异很大。由于VBD没有标准的治疗方案,该疾病仍需要合适的治疗工具。:通过对大量样本人群进行的多中心研究,开展了一项前瞻性观察性试验,以确认含有亚精胺 - 透明质酸复合物的局部凝胶(UBIGEL donna™)作为单独治疗或辅助治疗的疗效。:对于患有VBD的女性(n = 154),治疗包括根据UBIGEL的用药剂量进行约两个月(4 + 4周)的涂抹。对相关临床终点进行症状评估:通过视觉模拟量表(VAS)评估性交疼痛和外阴阴道疼痛/烧灼感;通过前庭营养健康(VeTH)评分评估前庭营养状况;通过棉拭子试验进行外阴镜检查;通过对肛提肌高张进行物理分级评估来评估高张盆底的程度。:总共154名接受UBIGEL donna™治疗的患者在所有五个评估参数上均有显著改善,包括疼痛、性交疼痛、棉拭子试验结果、肌肉高张和前庭营养状况。疼痛和性交疼痛评分分别下降了46.5%和33.5%,同时在其他参数上也观察到了显著改善(< 0.0001)。这些改善在包括年龄和病程在内的各种分层中都是一致的。:本研究结果表明,UBIGEL donna™在缓解VBD女性的疼痛和性交疼痛以及降低前庭超敏反应方面是有效的。虽然单独使用UBIGEL donna™不能完全替代所有推荐疗法,但我们建议多模式治疗策略对于在病情的任何方面取得实质性改善可能至关重要。

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