Use of 2 Nasal Sprays Combined Relieves Seasonal Allergic Rhinitis Nasal Congestion: Presented at EAACI
By Sara Freeman

LONDON -- June 11, 2010 -- The daily combined use of 2 nasal sprays, one containing an inhaled nasal steroid (INS) and the other containing a decongestant, can give significant relief from the nasal congestion experienced by people with seasonal allergic rhinitis (SAR), according to a study presented here at the 29th Congress of the European Academy of Allergy and Clinical Immunology (EAACI).

Individually, mometasone furoate and oxymetazoline have demonstrated efficacy for the treatment of SAR, but their use in combination has not been well studied, said William Berger, MD, University of California, Irvine, Irvine, California, on June 7.

"Two attributes cited by patients as being important to them are 24-hour efficacy and rapid onset of action," Dr. Berger observed. Whereas mometasone furoate has been shown to provide continued relief from rhinoconjunctivitis through the day, oxymetazoline is known to have a fast onset of action.

Dr. Berger presented the findings of a phase 2, single-blind, placebo-controlled study that assessed the efficacy of 1 spray per nostril of INS 200 mcg daily combined with 1 or 3 daily sprays per nostril of the decongestant (0.05%) versus placebo.

A total of 426 patients were studied, with 145 randomised to INS plus 1 spray of oxymetazoline, 139 to INS plus 3 sprays of the decongestant, and 142 to placebo. Treatment was continued for at least 2 weeks.

Nasal congestion was assessed via instantaneous and reflective patient report and total nasal symptom scores (TNSS).

"Both mometasone furoate and oxymetazoline once-daily combinations were significantly superior to placebo in reducing nasal congestion severity and composite TNSS in subjects with SAR," Dr. Berger said.

"Other than the first 15-minute area-under-the-curve nasal congestion score, all outcomes were statistically similar. In other words, 1 spray of oxymetazoline versus 3 sprays in combination with mometasone showed significant improvement over placebo," he added.

Despite the positive findings, a commercial product containing both mometasone furoate and oxymetazoline will probably not be developed right away, Dr. Berger said, but clinicians could consider the joint use of INS with the decongestant in suitable patients.

Funding for this study was provided by the Schering Corporation, a subsidiary of Merck & Co. Inc.

[Presentation title: Concomitant Once-Daily Administration of Mometasone Furoate Nasal Spray With One Spray and Three Sprays of Oxymetazoline Is Effective for the Treatment of Subjects With Seasonal Allergic Rhinitis. Abstract 374]