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Oxymetazoline adds to the effectiveness of fluticasone furoate in the treatment of perennial allergic rhinitis.

Author(s): Baroody FM, Brown D, Gavanescu L, DeTineo M, Naclerio RM

Affiliation(s): Section of Otolaryngology-Head and Neck Surgery, University of Chicago Medical Center, and Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA.

Publication date & source: 2011-04, J Allergy Clin Immunol., 127(4):927-34. Epub 2011 Mar 5.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

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. Copyright (c) 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Page last updated: 2011-12-09

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