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CompletedNCT02709005Updated Dec 28, 2018Results posted

Safety and Efficacy of 5% Monolaurin Vaginal Gel Administered Intravaginally for the Treatment of Bacterial Vaginosis

A Phase 2 interventional study of 5% Monolaurin Vaginal Gel and Placebo in Bacterial Vaginosis, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Completed at 3 sites in United States. Open to female participants aged 18 Years to 50 Years. Per ClinicalTrials.gov, last updated 2018-12-28.

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
109
Allocation
Randomized
Ages
18 Years to 50 Years
Sex
Female
01

Study summary

This is a Phase II, Double-Blind, Randomized, Placebo-Controlled, Multi-center Trial enrolling 120 subjects with Bacterial Vaginosis who will be randomized at a ratio of 2:1 to receive active test article (5% Monolaurin Vaginal Gel) or placebo (vehicle). The primary objective is to assess the safety and tolerability of 5% Monolaurin Vaginal Gel compared to vehicle placebo gel (excipients only) and to assess the efficacy by clinical cure rate of 5% Monolaurin Vaginal Gel compared to vehicle placebo gel at Visit 2.

Read the detailed description

Bacterial vaginosis (BV) is a disease of the vagina caused by bacteria. The most common symptom of BV is an abnormal homogeneous off-white vaginal discharge (especially after sex) with an unpleasant smell. This is a Phase II, Double-Blind, Randomized, Placebo-Controlled, Multi-center Trial enrolling 120 women, 18-50 years old, with clinical evidence of bacterial vaginosis. Subjects will be randomized at a ratio of 2:1 to receive active test article (5% Monolaurin Vaginal Gel) or placebo (vehicle) as outpatient therapy. Subjects will be stratified by first time episode of bacterial vaginosis or recurrent bacterial vaginosis. The primary objectives of this study are: 1) To assess the safety and tolerability of 5% Monolaurin Vaginal Gel compared to Vehicle Placebo Gel (excipients only) and 2) To assess the efficacy by clinical cure rate of 5% Monolaurin Vaginal Gel compared to Vehicle Placebo Gel at Visit 2. The secondary objectives are : 1) To evaluate the therapeutic cure rate of 5% Monolaurin Vaginal Gel compared to Vehicle Placebo Gel at Visits 2 and 3, 2) To evaluate the clinical cure rate of 5% Monolaurin Vaginal Gel compared to Vehicle Placebo Gel at Visit 3, 3) To evaluate the changes in Nugent's criteria of vaginal bacterial flora at Visits 2 and 3. This study is expected to last for 13 months, with subject participation duration being 4 weeks.

02

Conditions studied

  • Bacterial Vaginosis

Keywords

  • Bacterial Vaginosis
  • Monolaurin Vaginal Gel
03

In context

Vaginosis, Bacterial

220 studies on the registry are indexed under Vaginosis, Bacterial; 36 are open to participants now.

This study's enrollment of 109 is close to the median of 100 across 187 interventional studies indexed under Vaginosis, Bacterial.

Browse Vaginosis, Bacterial studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,401 studies on the registry; 179 are open to participants now.

Of its 396 completed or terminated interventional studies of FDA-regulated products, 294 (74%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Non-pregnant, non-breastfeeding females between the ages of 18 and 50 years, inclusive
  • Women of childbearing potential* must agree to practice reliable contraception** for the 28-day period before enrollment through 30 days following treatment.

    *(not surgically sterile via tubal ligation, bilateral oophorectomy or hysterectomy, or who have not been postmenopausal for >/=1 year)

    ** Acceptable birth control methods for the purposes of this study may include, but are not limited to, abstinence from intercourse with a male partner, monogamous relationship with vasectomized partner, barrier methods to include condoms and diaphragms, intrauterine devices, and licensed hormonal methods. NuvaRing® contraceptive use will be prohibited from this study since the device can alter vaginal secretions

  • Presenting with signs of BV (as per Amsel Criteria). Subjects must meet any three of the four criteria for enrollment*

    *Presence of discharge, greater than or equal to 20% clue cells on wet prep, positive "whiff test" on KOH prep, vaginal pH of greater than 4.5

  • Not currently menstruating or expected to in the next 4 days
  • Able to understand and comply with planned study procedures
  • Willing to abstain from sexual intercourse, insertion of tampons, douches, or other intravaginal medications or objects between Visit 1 and Visit 2 and 48 hours prior to Visit 3
  • Provide written informed consent before initiation of any study procedures and be available for all study visits
  • No known history of HIV

Exclusion criteria

Exclusion Criteria:

-Signs or symptoms of vaginal/cervical/pelvic infection on screening or clinical diagnosis of vaginal/cervical/pelvic infection in the past 14 days.

  • (including but not limited to yeast vulvovaginitis, chlamydia, gonorrhea, trichomonas, genital ulcer disease, pelvic inflammatory disease). Self-treatment for presumed yeast vaginitis is not an exclusion if treatment was discontinued 7 days or greater prior to enrollment

    • Treatment for BV within the past 14 days
    • Cervical or vaginal high grade squamous intraepithelial dysplasia (HSIL), atypical glandular cells of uncertain significance (AGUS) or cervical intraepithelial neoplasia grade 2 (CIN2) or higher*
  • Atypical squamous cells of undetermined significance (ASCUS), low grade squamous intraepithelial lesion (LSIL) or cervical intraepithelial neoplasia grade 1 (CIN1) are acceptable. Individuals with a history of atypical glandular cells of uncertain significance (AGUS), HSIL or CIN2 and who have received subsequent evaluation and/or treatment with follow up normal PAP smear are eligible. Patient report will be accepted

    • History of undiagnosed vaginal bleeding
    • Use of a systemic, vaginal, or perineal antibiotic within 7 days prior to enrollment in this study
    • Use of an immunosuppressive or immunomodulatory drug* for two or more consecutive weeks within 6 months prior to enrollment
  • such as >0.5 mg/kg/day or >/=20 mg total dose/day of prednisone orally or >800 µg of inhaled beclomethasone (nasal and non-genital topical steroids are allowed)

    • History of allergic reactions attributed to compounds of similar chemical or biologic composition to Monolaurin Vaginal Gel
    • Uncontrolled concurrent illness*. Subjects with a history of organ or marrow transplant are excluded.
  • Including, but not limited to, ongoing or active infection, active liver, kidney or autoimmune diseases (a history of thyroid disease will be permitted as long as the thyroid disease is now stable), symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements

    • Acute illness within 3 days before receipt of study product (per investigator's discretion)
    • Pregnant women and women who are planning to become pregnant within 30 days after the final study dose, or women who are breastfeeding
    • Immunosuppression as a result of an underlying illness or treatment or use of anticancer chemotherapy or radiation therapy (cytotoxic) within the preceding 36 months
    • Active neoplastic disease* or a history of any hematologic malignancy. Active neoplastic disease is defined as neoplastic disease or treatment for neoplastic disease within the past 5 years
  • (excluding non-melanoma skin cancer)

    -Received an experimental agent* within 30 days before receipt of study product or expect to receive an experimental agent during the 1 month study period.

  • (vaccine, drug, biologic, device, blood product, or medication)

    • Any condition that would place the subject at an unacceptable risk of injury, render her unable to meet the requirements of the protocol, or that may interfere with successful completion of the study
    • A history of alcohol or drug abuse* during the previous 1 year that in the opinion of the site investigator would interfere with study procedures
  • For example, daily excessive alcohol use or frequent binge drinking as determined by the investigator, or daily marijuana use
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
109 participants (actual)

Study arms

  • Experimental
    5% Monolaurin Vaginal Gel

    80 subjects will receive 5% Monolaurin Gel twice daily for three successive days for a total of 6 doses

    Drug: 5% Monolaurin Vaginal Gel

  • Placebo comparator
    Vehicle Placebo

    40 subjects will receive placebo Gel twice daily for three successive days for a total of 6 doses

    Other: Placebo

Interventions

  • Drug5% Monolaurin Vaginal Gel

    Monolaurin Vaginal Gel is a clear and colorless, non-sterile glycol-based gel for vaginal administration , and commonly referred to as glycerol monolaurate (GML). Each subject will receive intravaginal gel twice daily for three successive days for a total of 6 doses. There will be 3 clinic visits over 30 days.

  • OtherPlacebo

    The placebo gel is a clear to opaque, colorless to light gray, non-sterile glycol-based gel for vaginal administration. The placebo gel contains the same excipients as the Monolaurin vaginal gel. Each subject will receive intravaginal gel twice daily for three successive days for a total of 6 doses. There will be 3 clinic visits over 30 days.

06

What researchers measure

Primary outcomes

  1. Number of Participants With Clinical Cure in Each Study Arm

    A clinical cure was defined by normal Amsel criteria, including: normal physiological vaginal discharge, whiff test negative for any amine "fishy" odor, saline wet mount less than 20% for clue cells, and vaginal pH is \<=4.5. All four criteria had to be normal with none of the clinical failure criteria met to be considered a clinical cure. A clinical failure was defined by at least one of the following: one or more abnormal Amsel criteria, early discontinuation of study therapy due to lack of treatment effect, use of any vaginosis therapy other than study product during the study, or in the investigator's opinion, required additional treatment for vaginosis.

    Time frame: Visit 2 (Day 8-15)

  2. Number of Participants Reporting Solicited Urogenital Adverse Events (AEs) Following the First Dose of the Study Product

    Solicited event assessments were captured on a memory aid starting on Day 1, the first day of therapy and continuing for 5 days. The participant recorded the presence and intensity of vulvovaginal solicited events on the memory aid. Any symptom that was present at the time that the participant was screened was considered as baseline and not reported as a solicited urogenital AE. However, if the symptom deteriorated during the reporting period, it was considered an AE. If a symptom was reported that was not present at baseline, it too was considered an AE. Any symptoms still present on Day 5 were followed by participant memory aid notations until symptom resolution. Solicited events collected include vaginal odor, vaginal pain, vaginal tenderness, vaginal itching, vaginal dryness, vaginal discharge, and vaginal inflammation. Severity of solicited events symptoms were graded as mild, moderate, or severe according to the grading table in the protocol.

    Time frame: Days 1 through 5

  3. Number of Participants Reporting Serious Adverse Events (SAEs) Considered Product-related

    The number of participants in each treatment group with product-related SAEs was assessed. An AE was considered "serious" if, in the view of either the investigator or sponsor, it resulted in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, or a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, a congenital anomaly/birth defect. Important medical events that may not result in death, be life-threatening, or require hospitalizations could be considered serious when, based upon appropriate medical judgment, they could jeopardize the participant and require medical or surgical intervention to prevent one of the outcomes listed. An AE was considered related if there was a reasonable possibility that the study product caused the AE, meaning that there is evidence to suggest a causal relationship between the study product and the AE.

    Time frame: Visit 1 (Day 1) through Visit 3 (Day 22-31)

Secondary outcomes

  1. Number of Participants With Therapeutic Cure in Each Study Arm

    Therapeutic cure was defined as both a clinical cure and a bacteriological cure. All four Amsel criteria had to be normal with none of the clinical failure criteria listed met to be considered a clinical cure, including normal physiological vaginal discharge, whiff test negative for any amine "fishy" odor, saline wet mount less than 20% for clue cells, and vaginal pH is \<=4.5. A clinical failure was defined by at least one of the following: one or more abnormal Amsel criteria, early discontinuation of study therapy due to lack of treatment effect, use of any vaginosis therapy other than study product during the study, or in the investigator's opinion, required additional treatment for vaginosis. A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score can range from 0 to 10. Bacteriological cure of BV was defined as a normal Nugent score of 0-3. Participants who were clinical failures, or had a Nugent score \>3 were therapeutic failures.

    Time frame: Visit 2 (Day 8-15)

  2. Number of Participants With Therapeutic Cure in Each Study Arm

    Therapeutic cure was defined as both a clinical cure and a bacteriological cure. All four Amsel criteria had to be normal with none of the clinical failure criteria listed met to be considered a clinical cure, including normal physiological vaginal discharge, whiff test negative for any amine "fishy" odor, saline wet mount less than 20% for clue cells, and vaginal pH is \<=4.5. A clinical failure was defined by at least one of the following: one or more abnormal Amsel criteria, early discontinuation of study therapy due to lack of treatment effect, use of any vaginosis therapy other than study product during the study, or in the investigator's opinion, required additional treatment for vaginosis. A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score can range from 0 to 10. Bacteriological cure of BV was defined as a normal Nugent score of 0-3. Participants who were clinical failures, or had a Nugent score \>3 were therapeutic failures.

    Time frame: Visit 3 (Day 22-31)

  3. Number of Participants With Nugent Score of 3 or Less (Negative for BV) in Each Study Arm

    A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score utilizes a 10-point scale for evaluation of vaginal flora. The Nugent score can range from 0 to 10. A score of 7 to 10 is consistent with BV while 4-6 is considered intermediate and 0-3 is negative for BV. Bacteriological cure of BV was defined as a normal Nugent score of 0-3.

    Time frame: Visit 2 (Day 8-15)

  4. Number of Participants With Nugent Score of 3 or Less (Negative for BV) in Each Study Arm

    A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score utilizes a 10-point scale for evaluation of vaginal flora. The Nugent score can range from 0 to 10. A score of 7 to 10 is consistent with BV while 4-6 is considered intermediate and 0-3 is negative for BV. Bacteriological cure of BV was defined as a normal Nugent score of 0-3.

    Time frame: Visit 3 (Day 22-31)

  5. Number of Participants With Nugent Score of 4-6 (Intermediate BV) in Each Study Arm

    A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score utilizes a 10-point scale for evaluation of vaginal flora. The Nugent score can range from 0 to 10. A score of 7 to 10 is consistent with BV while 4-6 is considered intermediate and 0-3 is negative for BV. Bacteriological cure of BV was defined as a normal Nugent score of 0-3.

    Time frame: Visit 2 (Day 8-15)

  6. Number of Participants With Nugent Score of 4-6 (Intermediate BV) in Each Study Arm

    A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score utilizes a 10-point scale for evaluation of vaginal flora. The Nugent score can range from 0 to 10. A score of 7 to 10 is consistent with BV while 4-6 is considered intermediate and 0-3 is negative for BV. Bacteriological cure of BV was defined as a normal Nugent score of 0-3.

    Time frame: Visit 3 (Day 22-31)

  7. Number of Participants With Clinical Cure in Each Study Arm

    A clinical cure was defined by normal Amsel criteria, including: normal physiological vaginal discharge, whiff test negative for any amine "fishy" odor, saline wet mount less than 20% for clue cells, and vaginal pH is \<=4.5. All four criteria had to be normal with none of the clinical failure criteria met to be considered a clinical cure. A clinical failure was defined by at least one of the following: one or more abnormal Amsel criteria, early discontinuation of study therapy due to lack of treatment effect, use of any vaginosis therapy other than study product during the study, or in the investigator's opinion, requires additional treatment for vaginosis. Participants who did not have enough information to determine a clinical cure or clinical failure status were not evaluable for clinical cure.

    Time frame: Visit 3 (Day 22-31)

  8. Number of Participants Experiencing Non-laboratory Non-solicited AEs Following the First Dose of the Study Product

    The number of participants who experienced non-laboratory, non-solicited AEs following the first dose of the study product through Visit 3 (Day 22-31) was assessed. Events involving laboratory parameters that were not collected as part of the protocol were counted as non-laboratory, non-solicited adverse events.

    Time frame: Visit 1 (Day 1) through Visit 3 (Day 22-31)

  9. Number of Participants Experiencing Laboratory AEs Following the First Dose of the Study Product

    The number of participants experiencing laboratory AEs following the first dose of the study product was assessed at Visit 2 (Day 8-15). A laboratory abnormality was considered an adverse event if there was a worsening of the laboratory value at Visit 2 from the baseline value and it increased in laboratory toxicity grading from the baseline toxicity grading. Protocol-defined hematology parameters assessed were white blood cells, hemoglobin, platelets, and neutrophils. Protocol-defined clinical chemistry parameters assessed were creatinine, AST, ALT, total bilirubin, and glucose (random).

    Time frame: Visit 2 (Day 8-15)

07

Results

Posted Dec 28, 2018

Participant flow

Women, 18-50 years old, with clinical evidence of bacterial vaginosis, were identified during a routine clinic visit, referred by their care provider, or recruited directly to the research clinic between May 11, 2016 and November 16, 2017.

Participant flow — Overall Study
Milestone5% Monolaurin Vaginal GelVehicle Placebo
Started7336
Completed6935
Not completed41
Withdrew: Lost to follow-up11
Withdrew: Withdrawal by subject30

Outcome measures

PrimaryNumber of Participants With Clinical Cure in Each Study Arm

A clinical cure was defined by normal Amsel criteria, including: normal physiological vaginal discharge, whiff test negative for any amine "fishy" odor, saline wet mount less than 20% for clue cells, and vaginal pH is \<=4.5. All four criteria had to be normal with none of the clinical failure criteria met to be considered a clinical cure. A clinical failure was defined by at least one of the following: one or more abnormal Amsel criteria, early discontinuation of study therapy due to lack of treatment effect, use of any vaginosis therapy other than study product during the study, or in the investigator's opinion, required additional treatment for vaginosis.

Time frame:
Visit 2 (Day 8-15)
Reported as:
Count of participants · Participants
Number of Participants With Clinical Cure in Each Study Arm
Participants5% Monolaurin Vaginal GelVehicle Placebo
Number of Participants With Clinical Cure in Each Study Arm118
Statistical analysis
  • 5% Monolaurin Vaginal Gel vs Vehicle Placebo · Fisher Exact · p = 0.420 (The test was conducted using a Fisher's exact test at the 5% two-sided level of significance level without adjustment for multiplicity.) · Risk difference (rd): -0.08 · 95% CI -0.26 to 0.08Difference in Proportion of Participants with Clinical Cure between 5% Monolaurin Vaginal Gel and Placebo Gel
PrimaryNumber of Participants Reporting Solicited Urogenital Adverse Events (AEs) Following the First Dose of the Study Product

Solicited event assessments were captured on a memory aid starting on Day 1, the first day of therapy and continuing for 5 days. The participant recorded the presence and intensity of vulvovaginal solicited events on the memory aid. Any symptom that was present at the time that the participant was screened was considered as baseline and not reported as a solicited urogenital AE. However, if the symptom deteriorated during the reporting period, it was considered an AE. If a symptom was reported that was not present at baseline, it too was considered an AE. Any symptoms still present on Day 5 were followed by participant memory aid notations until symptom resolution. Solicited events collected include vaginal odor, vaginal pain, vaginal tenderness, vaginal itching, vaginal dryness, vaginal discharge, and vaginal inflammation. Severity of solicited events symptoms were graded as mild, moderate, or severe according to the grading table in the protocol.

Time frame:
Days 1 through 5
Reported as:
Count of participants · Participants
Number of Participants Reporting Solicited Urogenital Adverse Events (AEs) Following the First Dose of the Study Product
Participants5% Monolaurin Vaginal GelVehicle Placebo
Any Symptom5021
Vaginal Odor106
Vaginal Pain165
Vaginal Tenderness102
Vulvar/Vaginal Itching239
Vaginal Dryness103
Vaginal Discharge128
Vulvar Inflammation92
Statistical analysis
  • 5% Monolaurin Vaginal Gel vs Vehicle Placebo · Fisher Exact · p = 0.200 (The test was conducted using a Fisher's exact test at the 5% two-sided level of significance level without adjustment for multiplicity.) · Risk difference (rd): 0.14 · 95% CI -0.06 to 0.33Difference in Proportion of Participants Experiencing Solicited Events between 5% Monolaurin Vaginal Gel and Placebo Gel
PrimaryNumber of Participants Reporting Serious Adverse Events (SAEs) Considered Product-related

The number of participants in each treatment group with product-related SAEs was assessed. An AE was considered "serious" if, in the view of either the investigator or sponsor, it resulted in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, or a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, a congenital anomaly/birth defect. Important medical events that may not result in death, be life-threatening, or require hospitalizations could be considered serious when, based upon appropriate medical judgment, they could jeopardize the participant and require medical or surgical intervention to prevent one of the outcomes listed. An AE was considered related if there was a reasonable possibility that the study product caused the AE, meaning that there is evidence to suggest a causal relationship between the study product and the AE.

Time frame:
Visit 1 (Day 1) through Visit 3 (Day 22-31)
Reported as:
Count of participants · Participants
Number of Participants Reporting Serious Adverse Events (SAEs) Considered Product-related
Participants5% Monolaurin Vaginal GelVehicle Placebo
Number of Participants Reporting Serious Adverse Events (SAEs) Considered Product-related00
Statistical analysis
  • 5% Monolaurin Vaginal Gel vs Vehicle Placebo · Risk difference (rd): 0
SecondaryNumber of Participants With Therapeutic Cure in Each Study Arm

Therapeutic cure was defined as both a clinical cure and a bacteriological cure. All four Amsel criteria had to be normal with none of the clinical failure criteria listed met to be considered a clinical cure, including normal physiological vaginal discharge, whiff test negative for any amine "fishy" odor, saline wet mount less than 20% for clue cells, and vaginal pH is \<=4.5. A clinical failure was defined by at least one of the following: one or more abnormal Amsel criteria, early discontinuation of study therapy due to lack of treatment effect, use of any vaginosis therapy other than study product during the study, or in the investigator's opinion, required additional treatment for vaginosis. A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score can range from 0 to 10. Bacteriological cure of BV was defined as a normal Nugent score of 0-3. Participants who were clinical failures, or had a Nugent score \>3 were therapeutic failures.

Time frame:
Visit 2 (Day 8-15)
Reported as:
Count of participants · Participants
Number of Participants With Therapeutic Cure in Each Study Arm
Participants5% Monolaurin Vaginal GelVehicle Placebo
Number of Participants With Therapeutic Cure in Each Study Arm21
Statistical analysis
  • 5% Monolaurin Vaginal Gel vs Vehicle Placebo · Fisher Exact · p = >0.999 (The test was conducted using a Fisher's exact test at the 5% two-sided level of significance level without adjustment for multiplicity.) · Risk difference (rd): 0.00 · 95% CI -0.13 to 0.08Difference in Proportion of Participants with Therapeutic Cure between 5% Monolaurin Vaginal Gel and Placebo Gel
SecondaryNumber of Participants With Therapeutic Cure in Each Study Arm

Therapeutic cure was defined as both a clinical cure and a bacteriological cure. All four Amsel criteria had to be normal with none of the clinical failure criteria listed met to be considered a clinical cure, including normal physiological vaginal discharge, whiff test negative for any amine "fishy" odor, saline wet mount less than 20% for clue cells, and vaginal pH is \<=4.5. A clinical failure was defined by at least one of the following: one or more abnormal Amsel criteria, early discontinuation of study therapy due to lack of treatment effect, use of any vaginosis therapy other than study product during the study, or in the investigator's opinion, required additional treatment for vaginosis. A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score can range from 0 to 10. Bacteriological cure of BV was defined as a normal Nugent score of 0-3. Participants who were clinical failures, or had a Nugent score \>3 were therapeutic failures.

Time frame:
Visit 3 (Day 22-31)
Reported as:
Count of participants · Participants
Number of Participants With Therapeutic Cure in Each Study Arm
Participants5% Monolaurin Vaginal GelVehicle Placebo
Number of Participants With Therapeutic Cure in Each Study Arm03
Statistical analysis
  • 5% Monolaurin Vaginal Gel vs Vehicle Placebo · Fisher Exact · p = 0.035 (The test was conducted using a Fisher's exact test at the 5% two-sided level of significance level without adjustment for multiplicity.) · Risk difference (rd): -0.09 · 95% CI -0.24 to -0.01Difference in Proportion of Participants with Therapeutic Cure between 5% Monolaurin Vaginal Gel and Placebo Gel
SecondaryNumber of Participants With Nugent Score of 3 or Less (Negative for BV) in Each Study Arm

A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score utilizes a 10-point scale for evaluation of vaginal flora. The Nugent score can range from 0 to 10. A score of 7 to 10 is consistent with BV while 4-6 is considered intermediate and 0-3 is negative for BV. Bacteriological cure of BV was defined as a normal Nugent score of 0-3.

Time frame:
Visit 2 (Day 8-15)
Reported as:
Count of participants · Participants
Number of Participants With Nugent Score of 3 or Less (Negative for BV) in Each Study Arm
Participants5% Monolaurin Vaginal GelVehicle Placebo
Number of Participants With Nugent Score of 3 or Less (Negative for BV) in Each Study Arm21
SecondaryNumber of Participants With Nugent Score of 3 or Less (Negative for BV) in Each Study Arm

A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score utilizes a 10-point scale for evaluation of vaginal flora. The Nugent score can range from 0 to 10. A score of 7 to 10 is consistent with BV while 4-6 is considered intermediate and 0-3 is negative for BV. Bacteriological cure of BV was defined as a normal Nugent score of 0-3.

Time frame:
Visit 3 (Day 22-31)
Reported as:
Count of participants · Participants
Number of Participants With Nugent Score of 3 or Less (Negative for BV) in Each Study Arm
Participants5% Monolaurin Vaginal GelVehicle Placebo
Number of Participants With Nugent Score of 3 or Less (Negative for BV) in Each Study Arm58
SecondaryNumber of Participants With Nugent Score of 4-6 (Intermediate BV) in Each Study Arm

A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score utilizes a 10-point scale for evaluation of vaginal flora. The Nugent score can range from 0 to 10. A score of 7 to 10 is consistent with BV while 4-6 is considered intermediate and 0-3 is negative for BV. Bacteriological cure of BV was defined as a normal Nugent score of 0-3.

Time frame:
Visit 2 (Day 8-15)
Reported as:
Count of participants · Participants
Number of Participants With Nugent Score of 4-6 (Intermediate BV) in Each Study Arm
Participants5% Monolaurin Vaginal GelVehicle Placebo
Number of Participants With Nugent Score of 4-6 (Intermediate BV) in Each Study Arm83
SecondaryNumber of Participants With Nugent Score of 4-6 (Intermediate BV) in Each Study Arm

A vaginal swab for bacteriological assessment of BV by Nugent criteria was performed. The Nugent score utilizes a 10-point scale for evaluation of vaginal flora. The Nugent score can range from 0 to 10. A score of 7 to 10 is consistent with BV while 4-6 is considered intermediate and 0-3 is negative for BV. Bacteriological cure of BV was defined as a normal Nugent score of 0-3.

Time frame:
Visit 3 (Day 22-31)
Reported as:
Count of participants · Participants
Number of Participants With Nugent Score of 4-6 (Intermediate BV) in Each Study Arm
Participants5% Monolaurin Vaginal GelVehicle Placebo
Number of Participants With Nugent Score of 4-6 (Intermediate BV) in Each Study Arm93
SecondaryNumber of Participants With Clinical Cure in Each Study Arm

A clinical cure was defined by normal Amsel criteria, including: normal physiological vaginal discharge, whiff test negative for any amine "fishy" odor, saline wet mount less than 20% for clue cells, and vaginal pH is \<=4.5. All four criteria had to be normal with none of the clinical failure criteria met to be considered a clinical cure. A clinical failure was defined by at least one of the following: one or more abnormal Amsel criteria, early discontinuation of study therapy due to lack of treatment effect, use of any vaginosis therapy other than study product during the study, or in the investigator's opinion, requires additional treatment for vaginosis. Participants who did not have enough information to determine a clinical cure or clinical failure status were not evaluable for clinical cure.

Time frame:
Visit 3 (Day 22-31)
Reported as:
Count of participants · Participants
Number of Participants With Clinical Cure in Each Study Arm
Participants5% Monolaurin Vaginal GelVehicle Placebo
Number of Participants With Clinical Cure in Each Study Arm105
Statistical analysis
  • 5% Monolaurin Vaginal Gel vs Vehicle Placebo · Fisher Exact · p = >0.999 (The test was conducted using a Fisher's exact test at the 5% two-sided level of significance level without adjustment for multiplicity.) · Risk difference (rd): 0.00 · 95% CI -0.18 to 0.14Difference in Proportion of Participants with Clinical Cure between 5% Monolaurin Vaginal Gel and Placebo Gel
SecondaryNumber of Participants Experiencing Non-laboratory Non-solicited AEs Following the First Dose of the Study Product

The number of participants who experienced non-laboratory, non-solicited AEs following the first dose of the study product through Visit 3 (Day 22-31) was assessed. Events involving laboratory parameters that were not collected as part of the protocol were counted as non-laboratory, non-solicited adverse events.

Time frame:
Visit 1 (Day 1) through Visit 3 (Day 22-31)
Reported as:
Count of participants · Participants
Number of Participants Experiencing Non-laboratory Non-solicited AEs Following the First Dose of the Study Product
Participants5% Monolaurin Vaginal GelVehicle Placebo
Number of Participants Experiencing Non-laboratory Non-solicited AEs Following the First Dose of the Study Product5220
SecondaryNumber of Participants Experiencing Laboratory AEs Following the First Dose of the Study Product

The number of participants experiencing laboratory AEs following the first dose of the study product was assessed at Visit 2 (Day 8-15). A laboratory abnormality was considered an adverse event if there was a worsening of the laboratory value at Visit 2 from the baseline value and it increased in laboratory toxicity grading from the baseline toxicity grading. Protocol-defined hematology parameters assessed were white blood cells, hemoglobin, platelets, and neutrophils. Protocol-defined clinical chemistry parameters assessed were creatinine, AST, ALT, total bilirubin, and glucose (random).

Time frame:
Visit 2 (Day 8-15)
Reported as:
Count of participants · Participants
Number of Participants Experiencing Laboratory AEs Following the First Dose of the Study Product
Participants5% Monolaurin Vaginal GelVehicle Placebo
Any Laboratory AE127
Hemoglobin decrease24
White blood cells Increase30
White blood cells Decrease10
Platelets Decrease10
Neutrophils Decrease20
Glucose Decrease10
Glucose Increase01
Creatinine Increase11
AST Increase10
ALT Increase12
Bilirubin Increase00

Adverse events

Collected over Solicited urogenital AEs were collected following the first dose of the study product (Day 1) through Day 5. Laboratory AEs were collected at Visit 2 (Day 8-15). Serious adverse events and non-laboratory non-solicited AEs were collected following the first dose of the study product (Day 1) through Visit 3 (Day 22-31).. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
5% Monolaurin Vaginal Gel0/72 (0%)0/72 (0%)59/72 (81.9%)
Vehicle Placebo0/37 (0%)0/37 (0%)28/37 (75.7%)
Most frequent other events
Showing 10 of 15
Most frequent other events
Event5% Monolaurin Vaginal GelVehicle Placebo
Vulvovaginal Burning SensationReproductive system and breast disorders30/724/37
Vulvovaginal PruritusReproductive system and breast disorders23/719/37
Vulvovaginal PainReproductive system and breast disorders22/715/37
Vaginal DischargeReproductive system and breast disorders12/718/37
Vaginal OdourReproductive system and breast disorders10/716/37
Vulvovaginal DrynessReproductive system and breast disorders10/713/37
Upper Respiratory Tract InfectionInfections and infestations4/725/37
Vulvovaginal InflammationReproductive system and breast disorders9/712/37
Haemoglobin decreasedInvestigations2/724/37
Vulvovaginal Mycotic InfectionInfections and infestations6/723/37

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)5% Monolaurin Vaginal GelVehicle PlaceboTotal
<=18 years000
Between 18 and 65 years7336109
>=65 years000
Age, Continuous
Age, Continuous(years)5% Monolaurin Vaginal GelVehicle PlaceboTotal
Mean29.7 ± 8.431.3 ± 8.430.2 ± 8.4
Sex: Female, Male
Sex: Female, Male(Participants)5% Monolaurin Vaginal GelVehicle PlaceboTotal
Female7336109
Male000
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)5% Monolaurin Vaginal GelVehicle PlaceboTotal
Hispanic or Latino415
Not Hispanic or Latino683199
Unknown or Not Reported145
Race (NIH/OMB)
Race (NIH/OMB)(Participants)5% Monolaurin Vaginal GelVehicle PlaceboTotal
American Indian or Alaska Native000
Asian101
Native Hawaiian or Other Pacific Islander112
Black or African American451964
White261137
More than one race055
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(participants)5% Monolaurin Vaginal GelVehicle PlaceboTotal
United States7336109
Nugent score <4
Nugent score <4(Participants)5% Monolaurin Vaginal GelVehicle PlaceboTotal
Count of participants729
Positive HIV, Chlamydia, or Neisseria gonorrhoeae test
Positive HIV, Chlamydia, or Neisseria gonorrhoeae test(Participants)5% Monolaurin Vaginal GelVehicle PlaceboTotal
Count of participants101
08

Study locations

3 sites
  • University of Iowa - Vaccine Research and Education Unit
    Iowa City, Iowa 52242-2600, United States
  • Duke Human Vaccine Institute - Duke Clinical Vaccine Unit
    Durham, North Carolina 27704, United States
  • Cincinnati Children's Hospital Medical Center - Infectious Diseases
    Cincinnati, Ohio 45229-3039, United States
09

References and documents

Study documents

  • Study protocol · May 23, 2017
  • Statistical analysis plan · Nov 2, 2017

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 28, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT02709005
Lead sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Responsible party
Sponsor
First posted
Mar 15, 2016
Start date
Apr 14, 2016
Primary completion
Dec 11, 2017
Completion
Dec 11, 2017
Results posted
Dec 28, 2018
Last update
Dec 28, 2018

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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