Vulvovaginal Candidiasis (VVC) is an infectious disease, also known as ‘Vaginal thrush’, ‘monilia’, and vulvovaginal candidosis. VVC is usually caused by the yeast species Candida albicans, an infection of vagina associated with itchy rash of the vulva. Common symptoms include itching, soreness or burning discomfort in the vagina and vulva, heavy white curd-like vaginal discharge and bright red rash affecting inner and outer parts of the vulva, sometimes spreading widely in the groin to include pubic areas, inguinal areas and thighs.
As reported in many epidemiology based studies, the prevalence of VVC is highest among women in their reproductive years: 55 percent of female university students report having had at least one healthcare provider-diagnosed episode by age 25 years, 29 to 49 percent of premenopausal women report having had at least one lifetime episode, and 9 percent of women report having had four or more infections in a 12-month period (i.e., recurrent vulvovaginal candidiasis [RVVC]). In women with an initial infection, the probability of RVVC was 10 percent by age 25 years, and 25 percent by age 50 years.
Generic drugs are dominating the current therapeutic market for vaginal disease. Diflucan (fluconazole), a highly selective small molecule inhibitor of fungal cytochrome P450 C-14 alpha demethylase (CYP51) from Pfizer is the top-selling medication in the market. The major companies focused on the research and development of therapies for Vulvovaginal Candidiasis are Pfizer, Medinova, Bayer, Ferrer, Cidara Therapeutics, Scynexis, Viamet Pharmaceuticals and Matinas BioPharma. The pipeline drugs such as Arasertaconazole, CD101 Topical, SCY-078, and VT-1161 are few mid stage emerging therapies being evaluated for the treatment of VVC.
In a most recent event in January 2017, Cidara Therapeutics completed enrollment in phase 2 RADIANT trial evaluating novel antifungal CD101 topical in vulvovaginal candidiasis. Ferrer Internacional S.A. is also ready for the Phase III clinical trial development for the treatment of vulvovaginal candidiasis. There are many aspects that remain to be elucidated regarding the disease pathogenesis and clinical outcomes. The management of the disease is still a clinical challenge for scientific community due to unexplained aspects of the disease. There is a significant unmet medical need in the field of effective treatments with positive safety profile for better clinical outcomes.