Zafirlukast in severe recurrent vulvo-vaginal candidiasis: an open label pilot study

D. J. White, A. Vanthuyne, P. M. Wood, Jonathan Geoffrey Ayres

    Research output: Contribution to journalArticle

    11 Citations (Scopus)

    Abstract

    Background: Recurrent vulvovaginal candidiasis (VVC) has been linked to allergic disease, particularly allergic rhinitis.

    Objective: A pilot study to assess the possible use of the leukotriene receptor antagonist zafirlukast as a treatment for recurrent VVC.

    Methods: 20 women with six or more symptomatic attacks of VVC in the past year ( at least four proved microbiologically). Clinical atopy determined by the International Study for Asthma and Allergies in Childhood (ISAAC) questionnaire assessed blindly. Monitoring by daily symptom diary and self taken vaginal swabs. Treatment with zafirlukast 20 mg twice daily for 24 weeks or until three microbiologically confirmed episodes of VVC. Response assessed by daily symptom diary and self taken vaginal swabs. Subjective response scales for improvement, side effects, and change in other allergic disease completed when stopping treatment. Semistructured telephone interview 1 year after stopping medication.

    Results: 14 patients (70%) reported a subjective response on the improvement response scale. Six (30%) showed a complete response with no further symptomatic attacks of VVC or negative swabs when symptomatic. Seven (37%) remained symptom free 18 months after entering the study-that is, 12 months after stopping therapy. 11 (58%) remained symptom free for at least 3 months after stopping therapy. This does not include one patient who remained symptom free but continued on zafirlukast because of an improvement in her asthma. There was no clear relation between response and atopic status. Six of nine atopic subjective responders reported improvements in other allergic symptoms. Side effects were minimal; one seemed clearly attributable to the drug.

    Conclusion: Zafirlukast offers a potential new treatment for recurrent VVC that requires confirmation in controlled studies.

    Original languageEnglish
    Pages (from-to)219-222
    Number of pages3
    JournalSexually Transmitted Infections
    Volume80
    Issue number3
    DOIs
    Publication statusPublished - Jun 2004

    Keywords

    • ALBICANS ALLERGEN IMMUNOTHERAPY
    • LEUKOTRIENE RECEPTOR ANTAGONIST
    • DOUBLE-BLIND
    • ASTHMA
    • VAGINITIS
    • RHINITIS
    • WOMEN
    • THERAPY
    • TRIAL

    Cite this

    Zafirlukast in severe recurrent vulvo-vaginal candidiasis: an open label pilot study. / White, D. J.; Vanthuyne, A.; Wood, P. M.; Ayres, Jonathan Geoffrey.

    In: Sexually Transmitted Infections, Vol. 80, No. 3, 06.2004, p. 219-222.

    Research output: Contribution to journalArticle

    White, D. J. ; Vanthuyne, A. ; Wood, P. M. ; Ayres, Jonathan Geoffrey. / Zafirlukast in severe recurrent vulvo-vaginal candidiasis: an open label pilot study. In: Sexually Transmitted Infections. 2004 ; Vol. 80, No. 3. pp. 219-222.
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    abstract = "Background: Recurrent vulvovaginal candidiasis (VVC) has been linked to allergic disease, particularly allergic rhinitis.Objective: A pilot study to assess the possible use of the leukotriene receptor antagonist zafirlukast as a treatment for recurrent VVC.Methods: 20 women with six or more symptomatic attacks of VVC in the past year ( at least four proved microbiologically). Clinical atopy determined by the International Study for Asthma and Allergies in Childhood (ISAAC) questionnaire assessed blindly. Monitoring by daily symptom diary and self taken vaginal swabs. Treatment with zafirlukast 20 mg twice daily for 24 weeks or until three microbiologically confirmed episodes of VVC. Response assessed by daily symptom diary and self taken vaginal swabs. Subjective response scales for improvement, side effects, and change in other allergic disease completed when stopping treatment. Semistructured telephone interview 1 year after stopping medication.Results: 14 patients (70{\%}) reported a subjective response on the improvement response scale. Six (30{\%}) showed a complete response with no further symptomatic attacks of VVC or negative swabs when symptomatic. Seven (37{\%}) remained symptom free 18 months after entering the study-that is, 12 months after stopping therapy. 11 (58{\%}) remained symptom free for at least 3 months after stopping therapy. This does not include one patient who remained symptom free but continued on zafirlukast because of an improvement in her asthma. There was no clear relation between response and atopic status. Six of nine atopic subjective responders reported improvements in other allergic symptoms. Side effects were minimal; one seemed clearly attributable to the drug.Conclusion: Zafirlukast offers a potential new treatment for recurrent VVC that requires confirmation in controlled studies.",
    keywords = "ALBICANS ALLERGEN IMMUNOTHERAPY, LEUKOTRIENE RECEPTOR ANTAGONIST, DOUBLE-BLIND, ASTHMA, VAGINITIS, RHINITIS, WOMEN, THERAPY, TRIAL",
    author = "White, {D. J.} and A. Vanthuyne and Wood, {P. M.} and Ayres, {Jonathan Geoffrey}",
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    T1 - Zafirlukast in severe recurrent vulvo-vaginal candidiasis: an open label pilot study

    AU - White, D. J.

    AU - Vanthuyne, A.

    AU - Wood, P. M.

    AU - Ayres, Jonathan Geoffrey

    PY - 2004/6

    Y1 - 2004/6

    N2 - Background: Recurrent vulvovaginal candidiasis (VVC) has been linked to allergic disease, particularly allergic rhinitis.Objective: A pilot study to assess the possible use of the leukotriene receptor antagonist zafirlukast as a treatment for recurrent VVC.Methods: 20 women with six or more symptomatic attacks of VVC in the past year ( at least four proved microbiologically). Clinical atopy determined by the International Study for Asthma and Allergies in Childhood (ISAAC) questionnaire assessed blindly. Monitoring by daily symptom diary and self taken vaginal swabs. Treatment with zafirlukast 20 mg twice daily for 24 weeks or until three microbiologically confirmed episodes of VVC. Response assessed by daily symptom diary and self taken vaginal swabs. Subjective response scales for improvement, side effects, and change in other allergic disease completed when stopping treatment. Semistructured telephone interview 1 year after stopping medication.Results: 14 patients (70%) reported a subjective response on the improvement response scale. Six (30%) showed a complete response with no further symptomatic attacks of VVC or negative swabs when symptomatic. Seven (37%) remained symptom free 18 months after entering the study-that is, 12 months after stopping therapy. 11 (58%) remained symptom free for at least 3 months after stopping therapy. This does not include one patient who remained symptom free but continued on zafirlukast because of an improvement in her asthma. There was no clear relation between response and atopic status. Six of nine atopic subjective responders reported improvements in other allergic symptoms. Side effects were minimal; one seemed clearly attributable to the drug.Conclusion: Zafirlukast offers a potential new treatment for recurrent VVC that requires confirmation in controlled studies.

    AB - Background: Recurrent vulvovaginal candidiasis (VVC) has been linked to allergic disease, particularly allergic rhinitis.Objective: A pilot study to assess the possible use of the leukotriene receptor antagonist zafirlukast as a treatment for recurrent VVC.Methods: 20 women with six or more symptomatic attacks of VVC in the past year ( at least four proved microbiologically). Clinical atopy determined by the International Study for Asthma and Allergies in Childhood (ISAAC) questionnaire assessed blindly. Monitoring by daily symptom diary and self taken vaginal swabs. Treatment with zafirlukast 20 mg twice daily for 24 weeks or until three microbiologically confirmed episodes of VVC. Response assessed by daily symptom diary and self taken vaginal swabs. Subjective response scales for improvement, side effects, and change in other allergic disease completed when stopping treatment. Semistructured telephone interview 1 year after stopping medication.Results: 14 patients (70%) reported a subjective response on the improvement response scale. Six (30%) showed a complete response with no further symptomatic attacks of VVC or negative swabs when symptomatic. Seven (37%) remained symptom free 18 months after entering the study-that is, 12 months after stopping therapy. 11 (58%) remained symptom free for at least 3 months after stopping therapy. This does not include one patient who remained symptom free but continued on zafirlukast because of an improvement in her asthma. There was no clear relation between response and atopic status. Six of nine atopic subjective responders reported improvements in other allergic symptoms. Side effects were minimal; one seemed clearly attributable to the drug.Conclusion: Zafirlukast offers a potential new treatment for recurrent VVC that requires confirmation in controlled studies.

    KW - ALBICANS ALLERGEN IMMUNOTHERAPY

    KW - LEUKOTRIENE RECEPTOR ANTAGONIST

    KW - DOUBLE-BLIND

    KW - ASTHMA

    KW - VAGINITIS

    KW - RHINITIS

    KW - WOMEN

    KW - THERAPY

    KW - TRIAL

    U2 - 10.1136/sti.2002.003491

    DO - 10.1136/sti.2002.003491

    M3 - Article

    VL - 80

    SP - 219

    EP - 222

    JO - Sexually Transmitted Infections

    JF - Sexually Transmitted Infections

    SN - 1368-4973

    IS - 3

    ER -