Recurrent Vulvovaginal Candidiasis (RVVC) - Market Outlook, Epidemiology, Competitive Landscape, and Market Forecast Report 2023 To 2033
Candida is a dimorphic fungus from the Ascomycota phylum that lives in the genitourinary, gastrointestinal, and respiratory tracts of more than 30% of healthy people. Changes in the symbiotic interaction between the fungus and the mucosal ecology are connected with mild to significant fungal dysbiosis, depending on the patient's health state and affected location.
75–80% of female will, at some point in their lives, have vaginal anaerobic bacterial vaginosis and Vulvovaginal candidiasis (VVC). Bacterial vaginosis contributes to 40% to 50% of all vaginal infections, whereas VVC accounts for 20% to 25% and trichomoniasis for 15% to 20%, which makes VVC the second most prevalent vaginal infection after anaerobic bacterial vaginosis, which is commonly caused by Candida albicans.
Some women 5-8% of reproductive age show recurrence of VVC infection, which makes it challenging to treat. Recurrent Vulvovaginal candidiasis (RVVC) can be defined as four or more confirmed cases within 12 months. Affect females can show symptoms such as redness, itching, burning during urination, dyspareunia, dysuria, and cottage cheese-like vaginal discharge.
In 90% of cases, Candida albicans are responsible; however, other species like Candida krusei, Candida tropicals, and Candida parapsilosis are also associated with recurrence.
RVVC presents two forms: primary and secondary. Primary RVVC is idiopathic, with unknown underlying factors. It affects healthy, immunocompetent women, most of whom lack identifiable triggers. Secondary RVVC involves frequent acute VVC episodes due to specific predisposing factors like hormone replacement therapy or diabetes mellitus.
Several risk factors may increase the RVVC infection, such as women who have sex with the same gender, oral and anal intercourse, female masturbation using saliva from their partners, and genital hygiene practices. Some studies suggested that relapse is responsible for recurrent vaginal infection: (i) During systemic antibiotic therapy, cultures initially clear of vaginal yeasts quickly become positive. (ii) after successful treatment of vulvovaginal candidiasis (VVC) with topical antimycotics, vaginal cultures become positive again in 20%-25% of cases within 30 days.
Treating patients with RVVC consists of the use of 10-14 days of induction therapy with a topical antifungal or fluconazole for 6 months. Currently, the USFDA has approved Vivjoa? (Osteseconazole) to reduce the incidence of recurrent vulvovaginal candidiasis (RVVC) in females with a history of RVVC who are not of reproductive potential and Brexafemme? (ibrexafungerp) for the treatment of adult and post-menarchal pediatric females with vulvovaginal candidiasis (VVC).
Several gaps should be filled to overcome the current needs: Patients and providers do not clearly distinguish acute VVC from RVVC; only topical options are available for pregnant women; and OTC treatments are overused.
The broad opportunity areas in RVVC include,
Closing statement: The estimated global burden of recurrent vulvovaginal candidiasis is high. However, given the changing age structure of the global female population and the prevalence of diseases that increase the risk for vulvovaginal candidiasis, it is likely to increase. As populations age and remain reasonably healthy, sexual activity also extends into middle and old age.
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Thelansis report on RVVC provides in-depth insights into the disease and patient segments, along with the areas of unmet need and drug development pipeline. The report answers key questions such as,
“It is important to confirm the specific strain of yeast before initiating treatment. Oral fluconazole, a commonly prescribed antifungal agent, lacks efficacy against nonalbicans yeast strains, accounting for a significant portion of fungal infections, approximately one in every five. Therefore, accurately identifying the yeast species is crucial for prescribing effective therapeutic interventions.” – US–based - Microbiologist.
"In managing recurrent infections, addressing contributing factors like intrauterine devices and diabetes is crucial. Diabetic patients should control blood sugar with medications other than SGLT2 inhibitors, as they may increase infection risk. Minimizing corticosteroids and antibiotics usage is also advised to maintain microbial balance." – Germany – based - Gynaecologist.
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