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Intranasal Mometasone in Children With Obstructive Sleep Apnea Due to Adenotonsillar Hypertrophy

Information source: Children's & Women's Health Centre of British Columbia
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Obstructive Sleep Apnea (Mild, Moderate, Severe) as Per Polysomnography

Intervention: Mometasone furoate nasal spray (Drug); Placebo (Drug)

Phase: Phase 3

Status: Withdrawn

Sponsored by: Children's & Women's Health Centre of British Columbia


Obstructive sleep apnea (OSA) in children is a disorder of breathing during sleep characterized by prolonged partial upper airway obstruction and/or intermittent complete obstruction (obstructive apnea) that disrupts normal breathing during sleep1. The condition occurs in 2-5% of children and can occur at any age, but it is most common in children between the ages of 2 to 62,3. Untreated OSA is associated with lung disease, heart disease, growth delay, poor learning and behavioral problems such as inattention and hyperactivity. The most common underlying risk factor for the development of OSA is enlargement of tonsils and adenoids. Given the potential risk of complications associated with surgery of the tonsils and adenoids, medications to shrink the adenoids without requiring surgery have been considered, in particular intranasal corticosteroids (INCSs) which is a nose spray. A recent Cochrane systematic review suggested a short-term benefit of INCSs in children with mild to moderate OSA4. The authors recommended that further randomised controlled studies were required to evaluate the efficacy of INCSs in children with OSA. In particular they recommended that future studies should employ sleep studies to look for any improvement with INCSs, and should include children with more severe OSA, as these are the patients at the greatest risk of complications of surgery and would benefit most from a non-surgical treatment. The purpose of this study is therefore to explore the efficacy of INCSs in children with the full spectrum of OSA severity, including sleep study analysis., and longer term follow-up.

Clinical Details

Official title: A Randomized Controlled Trial of Intranasal Mometasone in Children With Obstructive Sleep Apnea Due to Adenotonsillar Hypertrophy

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

Primary outcome: Apnea Hypopnea Index (AHI)

Secondary outcome:

Respiratory Disturbance Index

Desaturation index

Respiratory arousal index

Nadir of arterial oxygen saturation

Mean arterial oxygen saturation

Avoidance of surgical treatment for OSA

Clinical symptom score (based on parent repot of, for example, snoring, witnessed apnea, daytime sleepiness etc.)

Tonsillar size (on an ordinal scale from 0 [not visible] to +4 [tonsils touch])


Minimum age: 3 Years. Maximum age: 16 Years. Gender(s): Both.


Inclusion Criteria:

- Children between age 3 and 16 with objectively diagnosed OSA (mild, moderate, severe)

as per polysomnography (AHI ≥ 1/h, where AHI is the sum of obstructive and mixed apneas and obstructive hypopneas). Exclusion Criteria:

- Children with malformation syndromes or craniofacial anomalies

- Children with neuromuscular disorders

- Children with morbid obesity (body mass index ≥ 40)

- Children with asthma requiring steroid treatment

Locations and Contacts

BC Women's and Children's Hospital, Vancouver, British Columbia V6H 3N1, Canada
Additional Information

Starting date: May 2012
Last updated: July 28, 2015

Page last updated: August 23, 2015

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