Results of a multicenter prospective observational study of the efficacy of a combination medication containing tioconazole, tinidazole and lidocaine, in the form of vaginal suppositories, in the treatment of vulvovaginal infections in routine clinical practice (Angara study)

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  • Authors: Apolikhina I.A.1,2, Savicheva A.M.3, Dubrovina S.O.4, Kazakova S.N.5, Loginov A.B.6,7, Mingareeva K.N.8, Neufeld I.V.9, Saveljeva I.V.10, Sokolova T.M.11, Tapilskaya N.I.3, Boris D.A.1
  • Affiliations:
    1. Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
    2. I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
    3. D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology
    4. Rostov State Medical University, Ministry of Health of Russia
    5. Atlas Multidisciplinary Medical Center
    6. Pavlov First Saint-Petersburg State Medical University, Ministry of Health of Russia
    7. Maternity Hospital No. 6 named after Prof. V.F. Snegirev
    8. Bashkir State Medical University, Ministry of Health of Russia
    9. Saratov State Medical University named after V.I. Razumovsky, Ministry of Health of Russia
    10. Omsk State Medical University, Ministry of Health of Russia
    11. Novosibirsk State Medical University, Ministry of Health of Russia
  • Issue: No 6 (2026)
  • Pages: 197-208
  • Section: Exchange of Experience
  • Published: 17.07.2026
  • URL: https://journals.eco-vector.com/0300-9092/article/view/716538
  • DOI: https://doi.org/10.18565/aig.2026.182
  • ID: 716538

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Abstract

Objective. To assess the prevalence of various vulvovaginal infections (VVIs) and the clinical efficacy and safety of a medicinal product containing tioconazole, tinidazole and lidocaine, in the form of vaginal suppositories (Gynomax Plus), in women with VVIs in routine clinical practice.

Materials and methods. The study included 140 women aged 18–49 who were diagnosed with VVIs and were prescribed a three-day course of treatment with Gynomax Plus. The study assessed the rate of clinical treatment success and the rate of eradication of VVI pathogens, the rate of symptom disappearance, changes in the pH of vaginal discharge, as well as the rate of success in treating concomitant cervicitis, ease of use and safety.

Results. Among 140 patients included in the study, mixed VVIs were the most common (60.71%); candidal vulvovaginitis (27.14%), bacterial vaginosis (11.43%) and aerobic vaginitis (0.71%) were diagnosed less frequently. Clinical success was noted in 97.1% of patients at visit 2 (day 10–14) and persisted in 89.6% at visit 3 (day 28–30). The average time taken for abnormal vaginal discharge, a burning sensation and itching to disappear was 2.43–2.77 days; dyspareunia resolved more quickly (after 1.74 days). Furthermore, 85% of patients reported an improvement within the first day of using the medication. High microbiological effectiveness was observed: pathogen eradication was 100% for aerobic bacteria and 75-100% for most anaerobic microorganisms (including 75% for Gardnerella vaginalis and 100% for Atopobium vaginae), 100% for Mycoplasma hominis, 68.0% for Candida spp. and 50.0% for Ureaplasma spp. The treatment of concomitant cervicitis was successful in 92.9% of cases. The mean pH decreased from 5.42±0.89 to 4.37±0.60. Adverse events were reported in 4.3% of patients (6/138); these were mild and were not associated with the treatment.

Conclusion. In routine clinical practice, mixed vaginal infections are the most common. The medicinal product «Gynomax Plus» has demonstrated high clinical efficacy, significant eradication of VVI pathogens, high efficacy in the treatment of concomitant cervicitis, and a favorable safety profile.

About the authors

Inna A. Apolikhina

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Author for correspondence.
Email: i_apolikhina@oparina4.ru
ORCID iD: 0000-0002-4581-6295

Dr. Med. Sci., Professor, Head of the Department of Aesthetic Gynecology and Rehabilitation, Professor, Department of Obstetrics, Gynecology, Perinatology and Reproductology

Russian Federation, Moscow; Moscow

Alevtina M. Savicheva

D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology

Email: savitcheva@mail.ru
ORCID iD: 0000-0003-3870-5930

Dr. Med. Sci., Professor, Honored Scientist of the Russian Federation, Head of the Department of Medical Microbiology

Russian Federation, St. Petersburg

Svetlana O. Dubrovina

Rostov State Medical University, Ministry of Health of Russia

Email: s.dubrovina@gmail.com

Professor, Dr. Med. Sci., Chief Researcher, Obstetrics and Pediatrics Research Institute, Professor at the Department of Obstetrics and Gynecology No. 1

Russian Federation, Rostov-on-Don

Svetlana N. Kazakova

Atlas Multidisciplinary Medical Center

Email: s-juice@mail.ru
ORCID iD: 0000-0003-1273-213X

PhD, obstetrician-gynecologist

Russian Federation, Moscow

Alexander B. Loginov

Pavlov First Saint-Petersburg State Medical University, Ministry of Health of Russia; Maternity Hospital No. 6 named after Prof. V.F. Snegirev

Email: i_apolikhina@oparina4.ru

PhD, Associate Professor, Department of Obstetrics, Gynecology and Neonatology, deputy Chief Physician

Russian Federation, St. Petersburg; St. Petersburg

Karina N. Mingareeva

Bashkir State Medical University, Ministry of Health of Russia

Email: mkn1805@mail.ru
ORCID iD: 0000-0001-9125-2614

PhD, Associate Professor at the Department of Obstetrics and Gynecology No. 2

Russian Federation, Ufa

Irina V. Neufeld

Saratov State Medical University named after V.I. Razumovsky, Ministry of Health of Russia

Email: i_apolikhina@oparina4.ru

PhD, Associate Professor, Head of the Educational Part of the Department of Obstetrics and Gynecology

Russian Federation, Saratov

Irina V. Saveljeva

Omsk State Medical University, Ministry of Health of Russia

Email: saveljeva_iv_omsk@mail.ru
ORCID iD: 0000-0001-9342-7342

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No. 1, Freelance Specialist in Obstetrics and Gynecology of the Ministry of Health of the Omsk region

Russian Federation, Omsk

Tatyana M. Sokolova

Novosibirsk State Medical University, Ministry of Health of Russia

Email: tatyana3965@mail.ru
ORCID iD: 0000-0003-3435-3536

Dr. Med. Sci., Professor, Department of Obstetrics and Gynecology

Russian Federation, Novosibirsk

Natalia I. Tapilskaya

D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology

Email: tapnatalia@mail.ru
ORCID iD: 0000-0001-5309-0087

Dr. Med. Sci., Professor, Head of the Department of Gynecology and Endocrinology

Russian Federation, St. Petersburg

Daiana A. Boris

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: dayana_boris@mail.ru
ORCID iD: 0000-0002-0387-4040

obstetrician-gynecologist, doctor of ultrasound diagnostics, Senior Researcher at the Department of Aesthetic Gynecology and Rehabilitation

Russian Federation, Moscow

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