Allergic Rhinitis Clinical Trial
Official title:
A Combination of Intranasal Steroid/Oxymetazoline Leads to Faster Relief of Nasal Congestion Without Inducing Rhinitis Medicamentosa
We hypothesize that once daily use of oxymetazoline will not cause significant rhinitis medicamentosa and that the combination of fluticasone furoate plus oxymetazoline leads to faster relief of nasal congestion secondary to perennial allergic rhinitis than the use of fluticasone furoate alone.
We performed a 6-week, 4-group, parallel, randomized, double-blind, double-dummy, clinical
trial in 60 patients with perennial allergic rhinitis. After an initial screening with an
allergy questionnaire and skin puncture testing to confirm an allergic response to a
perennial allergen (cat, dog, dust mite, indoor mold), qualified individuals were randomized
into 1 of 4 treatment groups. The 4 groups received the following treatments: placebo, OXY
(0.05%, 2 puffs in each nostril every evening), FF nasal spray (110 mg per day), and FF
nasal spray plus OXY (FF/OXY). All participants received 2 nasal sprays at night, with 1
spray containing FF or its placebo, the other oxymetazoline or its placebo. The nasal sprays
were labeled with participant code numbers, and the investigator assigned participants in a
sequential randomized fashion to a study code number in blocks of 4. Dropouts were replaced
until 60 subjects were randomized. Replacement subjects were assigned the next sequential
treatment. Thus, the number of subjects in each group was not exactly 15.
Eligible participants completed the Rhinitis Quality of Life Questionnaire (RQLQ) and
underwent measurement of nasal volume by acoustic rhinometry before starting the study.
Participants were instructed to keep a diary of daily symptoms, nasal peak inspiratory flow
(NPIF) meter readings, and medication use during the study; no rescue medications were
allowed. The severity of sneezing, rhinorrhea, nasal congestion, and other symptoms was
recorded in the morning (reflective of symptoms overnight) and evening (reflective of
daytime symptoms) on a 0 to 3 scale. Intake of the study medication was performed once
daily, at night, after recording of symptoms and NPIF values. Subjects returned to the nasal
laboratory every 2 weeks for a total of 4 weeks for review of the symptom diaries,
replacement of medications, performance of acoustic rhinometry, and completion of the RQLQ.
After the fourth week, participants stopped treatment, returned medication, and continued
with the clinical trial for 2 additional weeks. During this time, they maintained symptom
diaries and NPIF measurements twice daily. At the end of the 2-week period, participants
returned to the nasal laboratory to perform a final acoustic rhinometry, complete an RQLQ
survey, and return the diaries.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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