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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00335283
Other study ID # 051169
Secondary ID
Status Completed
Phase Phase 3
First received June 7, 2006
Last updated July 17, 2012
Start date August 2006
Est. completion date December 2008

Study information

Verified date June 2012
Source Vanderbilt University
Contact n/a
Is FDA regulated No
Health authority United States: Institutional Review Board
Study type Interventional

Clinical Trial Summary

The purpose of this study is to determine whether aggressive acid suppression with Lansoprazole is effective in the treatment of post nasal drip, and also assess the predictors of response based on clinical and physiologic parameters.


Description:

Postnasal drip (PND) is a common complaint that brings patients to the attention of their primary care physicians. It is also one of the most common reasons for patients to seek care from otolaryngologists. Traditionally, PND has been considered and treated as a symptom of sinonasal pathology. It has also been shown, along with Gastroesophageal reflux disease (GERD) and asthma, to be a major contributor to the development of chronic cough. PND refractory to treatment aimed at sinonasal disease is sometimes treated with anti-GERD therapy. This treatment modality is based on clinical experience. To date, there are no studies in the literature to support a causal relationship between PND and extraesophageal reflux (EER). In a case control study of patients with and without esophagitis El-Serag et al reported a significant association (odds ratio 1.6, 95%CI 1.4-1.8) between sinusitis and GERD. A later study by Ulualp et al in 11 CT confirmed cases of chronic sinusitis resistant to therapy with conventional sinus therapies they found a significantly higher prevalence of hypopharyngeal acid exposure in the sinusitis group than controls. Recently, in an open label prospective pilot trial, DiBaise et al treated 11 patients with sinusitis and 19 GERD patients with omeprazole 20mg bid for 3-months. 9/11 sinusitis patients were found to have GERD by pH monitoring and there was moderate (25-89%) improvement in the sinus symptoms in the omeprazole treated group. However, there are currently no placebo-controlled trials assessing efficacy of PPI's in patients with PND.


Recruitment information / eligibility

Status Completed
Enrollment 75
Est. completion date December 2008
Est. primary completion date December 2008
Accepts healthy volunteers No
Gender Both
Age group 18 Years and older
Eligibility Inclusion Criteria:

- Negative RAST inhalant allergy panel OR negative skin testing (Group A)

- Positive RAST or Positive skin testing AND insufficient response to all of the following: (Group B)

- Allergen avoidance

- Topical nasal steroids

- Allergy shots if indicated

- Antihistamines

- Negative CT sinuses (coronal)

- < 4mm of mucosal thickening and < 3 sinus sites

- Absence of air-fluid levels

- Negative anterior rhinoscopy

- Absence of pus, crusts on mucosal surfaces

Exclusion Criteria:

- Age < 18

- Pregnancy, confirmed by urine pregnancy test at day of randomization

- Ciliary dyskinesia

- Immune deficiency

- Cystic fibrosis

- Diagnosis of acute sinusitis or chronic RS (AAO-HNS)

- Active use of topical decongestant

- Use of PPI within the last 30 days

- Previous fundoplication

- Uncontrolled thyroid disease

- Isolated chronic cough without the symptom of post nasal drip

Study Design

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


Related Conditions & MeSH terms


Intervention

Drug:
Lansoprazole Tablet
40 mg bid x 16 weeks
Procedure:
PH and impedence testing
24 hour ph monitoring
manometry
done prior to pH probe to measure length of esophagus
Drug:
lansoprazole
40mg bid
placebo
one tablet bid

Locations

Country Name City State
United States Vanderbilt University Medical Center, Vanderbilt Digestive Disease Clinic, TVC, Room 1660 Nashville Tennessee

Sponsors (2)

Lead Sponsor Collaborator
Vanderbilt University TAP Pharmaceutical Products Inc.

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Post Nasal Drainage Symptom Response The primary outcome measure was postnasal drainage symptom response measured by using a visual analogue scale. At 8 and 16 weeks, a horizontal symptoms scale from 0% (no change) to 100% (symptoms completely resolved) was presented to participants to assess improvement in postnasal drainage symptoms. 8 and 16 weeks No
Secondary Rhinosinusitis Outcome Measure(RSOM-31) RSOM-31 includes 31 questions combined into a total score ranging from 0 to 155 with higher scores representing greater disease burden. Values are based on patient report. Baseline, 8 weeks, and 16 weeks No
Secondary Sino Nasal Outcome Test (SNOT-20) SNOT-20 includes 20 questions combined into a total score ranging from 0 to 100 with higher numbers representing greater rhinosinusitis health burden and represents patient-reported symptom severity. Baseline, 8 weeks and 16 weeks No
Secondary Quality of Life Questionnaire (QOLRAD) The patient-reported QOLRAD consists of 25 questions combined into a total score ranging from 25 to 175 with higher numbers representing better quality of life. Baseline, 8 weeks and 16 weeks No
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