Efficacy and Safety of Sinusitis Hevert SL Tablets Compared to Placebo in Adult Patients With Acute, Uncomplicated Rhinosinusitis

Acute Rhinosinusitis Clinical Trial

— CESAR  

Official title:

Efficacy and Safety of Sinusitis Hevert SL Tablets Compared to Placebo in Adult Patients With Acute, Uncomplicated Rhinosinusitis. A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel Group Phase IV Study (Sinusitis Study)

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02296814
• Other study ID #: SHDE-1
• Secondary ID: 2014-000907-29DR
• Status: Completed
• Phase: Phase 4
• First received: November 7, 2014
• Last updated: July 16, 2015
• Start date: November 2014
• Est. completion date: April 2015

Study information

• Verified date: July 2015
• Source: Hevert-Arzneimittel GmbH & Co. KG
• Contact: n/a
• Is FDA regulated: No
• Health authority: Germany: Federal Institute for Drugs and Medical Devices
• Study type: Interventional

Clinical Trial Summary

Study to verify the efficacy and tolerability of Sinusitis Hevert SL tablets compared to placebo in adult patients with acute, uncomplicated rhinosinusitis (inflammation of the nasal and paranasal sinuses).

Description:

Acute rhinosinusitis is one of the most common diseases worldwide with a prevalence of 6-15% and a large impact on quality of life and socioeconomics. The majority of infections are of viral origin, while acute bacterial infection occurs in only 0.5-2% of cases. Currently available treatment includes a variety of remedies, like analgesic, inhalation with water steam of diluted drugs, nasal douche or spray, decongestant and mucolytic remedies as well as antibiotics.

Sinusitis Hevert SL is registered since 2003 for the treatment of inflammation of the nose and throat region and the sinuses (sinusitis) and contains eleven homeopathic single substances which are classically used in homeopathy for this condition, but has not been evaluated in a randomized controlled clinical trial. In this multicenter, randomized, double-blind, placebo-controlled, parallel group phase IV study the efficacy and safety of Sinusitis Hevert SL tablets compared to placebo in adult patients with acute, uncomplicated rhinosinusitis shall be demonstrated.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 314
• Est. completion date: April 2015
• Est. primary completion date: April 2015
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

1. Signed informed consent

2. Male and female outpatients, aged = 18 and = 75 years

3. Diagnosis of acute, uncomplicated (or recurrent acute) rhinosinusitis

• characterized by Major Rhinosinusitis Symptom Score (MRSSinv) = 8 and = 15 points

• individual score for facial pain/pressure (on bending) = 1 (mild) and = 2 (moderate)

• with presence of symptoms = 3 days prior to inclusion Out of the 5 main rhinosinusitis symptoms, at least 3 must be present. Among these, the presence of nasal congestion and facial pain / pressure (on bending) is mandatory.

4. Women of childbearing potential: willingness to use contraception methods

Exclusion Criteria:

Medical history

• Diseases

1. Chronic rhinosinusitis (i.e. all forms and causes of persistent chronic rhinosinusitis)

2. Polyposis nasi, recent history

3. Infection of dental origin in the maxilla

4. Cystic fibrosis, recent history

5. Anatomical deviations of the nasal septum that significantly impair nasal and paranasal ventilation / air flow

6. Acute symptoms of a known allergic rhinitis

7. History of smoking within the last two years prior to study enrolment or current smoking habits

8. Patients with asthma

9. Known hypersensitivity to study medication or excipients (asteraceae, lactose, allergy to bee venom, etc.)

10. Underlying diseases leading to a significant immune deficiency

11. Signs or symptoms of bacterial sinusitis requiring antibiotic treatment (e.g. fever >38.3°C, orbital complications, severe unilateral frontal headache or toothache)

12. Patients with progressive auto-immune diseases, tuberculosis, leukemia or leukemia-like diseases, multiple sclerosis, inflammatory diseases of the connective tissues, rheumatoid arthritis, Lupus erythematodes, HIV infection or other chronic viral diseases

13. Patients with untreated/unstable thyroid gland disorder (treatment should not include iodine supplementation)

14. Pre-menopausal women (last menstruation = 1 year prior to informed consent) who:

• are nursing or pregnant,

• or are of child-bearing potential and are not practicing an acceptable method of birth control, or do not plan to continue using this method throughout the study. Acceptable methods of birth control include transdermal patch, intra uterine devices/systems (IUDs/IUSs), oral, implantable or injectable contraceptives, double barrier methods, sexual abstinence and vasectomised partner.

15. Severe diseases of liver or kidney 16. Severe somatopathic, neurological and / or psychiatric diseases 17. Patients with malignant growth processes or cancer treatment within the last two years prior to study inclusion.

18. History of alcohol or drug abuse

• Medication

1. Treatment with systemic or nasal antibiotics or nasal or systemic corticosteroids within the last 4 weeks prior to study inclusion

2. Treatment with alternative medicine preparations (homeopathic and phytotherapeutical drugs) for treatment of common cold like symptoms or with immunomodulating properties (such as Echinacea), within the last 7 days prior to study inclusion

3. Treatment with decongestant (a-sympathomimetics on the day of study inclusion within 5 hours prior to screening and during the study)

4. Chronic use of decongestant remedies

5. Treatment with immunosuppressive medication 8 weeks prior to study inclusion and during the study for any condition

6. Systemic antiviral treatment such as aciclovir; zanamivir, or oseltamivir within 30 days prior to study inclusion

7. Patients requiring antibiotic treatment for any condition at study entry

• General

1. Parallel participation in any other clinical study or participation in another study within less than 6 weeks prior to study inclusion, or previous participation in this same study

2. Legal incapacity and / or other circumstances rendering the patient unable to understand the nature, scope and possible impact of the study

3. Patients in custody by juridical or official order

4. Patients who have difficulties in understanding the language (German) in which the patient information is given

5. Patients who are employees of a trial center, the CRO, the sponsor or its authorised representatives or are relatives either of the study site staff, the CRO staff; the sponsor staff or its authorised representatives

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Related Conditions & MeSH terms

• Acute Rhinosinusitis
• Sinusitis

Intervention

Drug:
• Sinusitis Hevert SL Tablet
1st week: 6 times daily 2 tablets and 2nd week: 4 times daily 2 tablets
• Placebo for Sinusitis Hevert SL Tablet
1st week: 6 times daily 2 tablets and 2nd week: 4 times daily 2 tablets

Locations

Country	Name	City	State
Germany	Immanuel Krankenhaus Berlin	Berlin
Germany	Site in Berlin	Berlin
Germany	Site in Bochum	Bochum
Germany	Site in Chemnitz	Chemnitz
Germany	Site in Dresden	Dresden
Germany	Site in Duisburg	Duisburg
Germany	Site in Düren	Düren
Germany	Site in Essen	Essen
Germany	Site in Frankfurt am Main	Frankfurt am Main
Germany	Site in Gars am Inn	Gars am Inn
Germany	Site in Goch	Goch
Germany	Site in Haag	Haag
Germany	Site in Hamburg	Hamburg
Germany	Site in Heidelberg	Heidelberg
Germany	Site in Köln	Köln
Germany	Site in Künzing	Künzing
Germany	Site in Leipzig	Leipzig
Germany	Site in Röthenbach	Röthenbach
Germany	Site in Wiesbaden	Wiesbaden
Germany	Site in Wolmirstedt	Wolmirstedt

Sponsors (1)

Lead Sponsor	Collaborator
Hevert-Arzneimittel GmbH & Co. KG

Country where clinical trial is conducted

Germany, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Rate of responders	Rate of responders which occur between baseline and 14 days after baseline (V4). A response is defined as stable reduction of MRSSpat (sum of 5 main rhinosinusitis symptoms daily assessed by the patient) by at least 50%, i.e. reduction by at least 50% and no subsequent change from baseline = 50% up to treatment termination.	2 weeks	No
Primary	Rate of remissions	Rate of remissions which occur between baseline and V4. A remission is defined as complete disappearance of all 5 main rhinosinusitis symptoms with no subsequent reoccurrence of any symptom up to treatment termination.	2 weeks	No
Secondary	Time to response	a) Time to response	2 weeks	No
Secondary	Change in the overall MRSSinv (main symptoms)	Change in the overall MRSSinv (sum of 5 main rhinosinusitis symptoms, assessed by the Investigator) at V2 (7 days after baseline), V3 (10 days after baseline) and V4 (14 days after baseline), as well as in the time course of the study	2 weeks	No
Secondary	Change in the overall MRSSinv (remaining symptoms)	Change in the overall MRSSinv (sum of the remaining symptoms, assessed by the Investigator) at V2, V3 and V4, as well as in the time course of the study	2 weeks	No
Secondary	Time to disappearance	Time to disappearance in the individual MRSSpat symptoms (in case of positive baseline value)	2 weeks	No
Secondary	Time to improvement	Time to improvement in the individual MRSSpat symptoms (in case of positive baseline value)	2 weeks	No
Secondary	Time to remission	Time to remission	2 weeks	No
Secondary	Change in the individual MRSSinv symptoms	Change in the individual MRSSinv symptoms, assessed by the Investigator, between baseline and V2, V3 and V4, as well as in the time course of the study	2 weeks	No
Secondary	SNOT-20 GAV	Change in the Sino-Nasal Outcome Test, German Adapted Version (SNOT-20 GAV), in the Overall Score (OS) as well as in the sub scores PNS (Primary Nasal Symptoms), SRS (Secondary Rhinogenous Symptoms, and Quality of Life Score (GQOL), assessed by the patient between baseline and V2, V3 and V4; Change in the SNOT-20 GAV, score of 5 most important symptoms, assessed by the patient between baseline and V2, V3 and V4; Change in the SNOT-20 GAV, individual symptoms, assessed by the patient between baseline and V2, V3 and V4, respectively	2 weeks	No
Secondary	VASpat	Change in the assessment of health status by patient using a Visual Analogue Scale (VASpat) using a 10-cm scale (0= best state of health to 10= worst state of health) between baseline and V2, V3 and V4	2 weeks	No
Secondary	VASinv	Change in the assessment of the patient's health status by the investigator using a Visual Analogue Scale (VASinv) between baseline and V4	2 weeks	No
Secondary	Change in the assessment of the patient's health status	Change in the assessment of the patient's health status by the investigator using a Visual Analogue Scale (VASinv) between baseline and V4	2 weeks	No
Secondary	General assessment of efficacy	General assessment of efficacy by the investigator (on a 4-point rating scale) at each visit from V2 to V4	2 weeks	No
Secondary	Rescue medication	Use of antibiotics / allowed rescue medication	2 weeks	No