Oxymetazoline adds to the effectiveness of fluticasone furoate in the treatment of perennial allergic rhinitis - 11/08/11
Reprint requests: Robert M. Naclerio, MD, Section of Otolaryngology-Head and Neck Surgery, 5841 S Maryland Ave, MC 1035, Chicago, IL 60637.Abstract |
Background |
In clinical trials, only about 60% of subjects report an excellent response to intranasal steroids, suggesting a need to add therapies to intranasal steroids to provide additional efficacy.
Objective |
To determine whether the combination of fluticasone furoate and oxymetazoline is more efficacious than either agent alone, and to determine whether rhinitis medicamentosa develops after treatment.
Methods |
We performed a double-blind, double-dummy, randomized, placebo-controlled parallel study. Sixty patients with perennial allergy were randomized to 4 weeks of once-a-night treatment with fluticasone furoate, oxymetazoline hydrochloride, the combination, or placebo. They were monitored during treatment and for 2 weeks posttreatment.
Results |
The total nasal symptom score over the 4 weeks of treatment was lower with the combination (median, 143; range, 30-316) compared with treatment with placebo (262; 116-358) and oxymetazoline alone (219; 78-385; ANOVA, P = .04). When acoustic rhinometry was compared between the groups at the end of 4 weeks of treatment, the combination resulted in significantly higher nasal volume (mean + SEM, 15.8 + 1.1 mL; P < .03) compared with both placebo (12.1 + 0.9 mL) and oxymetazoline (12.4 + 0.8 mL) alone. The quality of life data showed no significant differences among the groups. Peak flow showed a nonsignificant improvement with the groups on fluticasone furoate. There was no evidence of rhinitis medicamentosa.
Conclusion |
The addition of oxymetazoline adds to the effectiveness of fluticasone furoate in the treatment of perennial allergic rhinitis. The lack of development of rhinitis medicamentosa suggests the need for a large multicenter study to develop a once-a-day combination of an intranasal steroid and a long-acting topical decongestant.
El texto completo de este artículo está disponible en PDF.Key words : Allergic rhinitis, perennial, fluticasone furoate, oxymetazoline, clinical trial, rhinitis medicamentosa
Abbreviations used : FF, FF/OXY, NPIF, OXY, RQLQ
Esquema
| Supported in part by the McHugh Otolaryngology Research Fund and an Investigator Initiated Grant from GlaxoSmithKline. |
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| Disclosure of potential conflict of interest: F. M. Baroody is a speaker for Merck and has received research support from GlaxoSmithKline. R. M. Naclerio is a speaker for GlaxoSmithKline, Merck, and Sepracor; is a consultant for Boehringer Ingelheim; has received research support from GlaxoSmithKline, Merck, and McNeil; and is a member of the American Academy of Otolaryngology-Head and Neck Surgery and the American Academy of Allergy, Asthma & Immunology. |
Vol 127 - N° 4
P. 927-934 - avril 2011 Regresar al número
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