NCT02557269

Brief Summary

ASIT naïve patients sensitized to grass pollens will be recruited for the study. All of them will be instructed to treat bothersome in-season symptoms when they appear (on as needed, pro re nata basis) with rescue medication. They will be given 5 different options and will be informed about the effects of each of them in order to make their optimal choice for different symptoms and their combination: local decongestant (xylomethazoline, when congestion is leading), local antihistamine (azelastine, when itching, sneezing and rhinorhea a predominant), nasal corticosteroid (momethasone, when all nasal symptoms are pressing and no adequate relief is obtained form the other 2 local treatments), oral antihistamine (bilastine, when itching and sneezing persist despite the local treatments) and oral corticosteroid (prednisolone, when any or all symptoms become unbearable despite the other suggested treatments). Patients who are reluctant to use immunotherapy or who are too late to initiate it will be randomized to be treated with the listed medications on as needed basis, the nasally applied formulations will be followed by either HPMC to prolong and enhance their effect (Group HPMC) or placebo (lactose powder) (Group Placebo) to serve as control. Patients indicated and willing to carry out ASIT will be treated according to the standard protocol with grass allergens sublingually (Staloral #688) and will receive rescue medication (Group Immunotherapy).

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
60

participants targeted

Target at P25-P50 for phase_4

Timeline
Completed

Started May 2015

Shorter than P25 for phase_4

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 1, 2015

Completed
3 months until next milestone

First Submitted

Initial submission to the registry

July 17, 2015

Completed
2 months until next milestone

First Posted

Study publicly available on registry

September 23, 2015

Completed
8 days until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2015

Completed
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2015

Completed
Last Updated

September 23, 2015

Status Verified

September 1, 2015

Enrollment Period

5 months

First QC Date

July 17, 2015

Last Update Submit

September 21, 2015

Conditions

Keywords

PollenosisCongestionMucoadhesive TreatmentNasal DecongestantNasal AntihistamineNasal Corticosteroid

Outcome Measures

Primary Outcomes (1)

  • Combined Sypmtom and Medication Score

    The primary outcome will be comparison of total combined symptoms and medication scores (TCSMS) collected from patients' diaries for a fixed period during the pollen season

    Up to 6 months

Secondary Outcomes (2)

  • Drug Specific Combined Sypmtom and Medication Score

    Up to 6 months

  • Visual Analogue Scale

    Up to 6 months

Study Arms (3)

Group HPMC

ACTIVE COMPARATOR

Hydroxyl-propyl-methyl-cellulose (HPMC) powder added immediately after other intranasal treatment options

Drug: Xylometazoline - intranasal applicationDrug: Azelastine - intranasal applicationDrug: Mometasone furoate - intranasal applicationDrug: Hydroxyl-propyl-methyl cellulose powder - intranasal applicationDrug: Bilastine 20 mgDrug: Prednisolone 5 mg

Group Placebo

PLACEBO COMPARATOR

Lactose powder (placebo) added immediately after other intranasal treatment options

Drug: Xylometazoline - intranasal applicationDrug: Azelastine - intranasal applicationDrug: Mometasone furoate - intranasal applicationOther: Placebo - Lactose powderDrug: Bilastine 20 mgDrug: Prednisolone 5 mg

Group Immunotherapy

OTHER

Immunotherapy group with grass allergens sublingually (Staloral #688) and rescue medication

Drug: Xylometazoline - intranasal applicationDrug: Azelastine - intranasal applicationDrug: Mometasone furoate - intranasal applicationDrug: Bilastine 20 mgDrug: Prednisolone 5 mg

Interventions

Applied as needed up to 5 consecutive days when prominent congestion

Group HPMCGroup ImmunotherapyGroup Placebo

Applied as needed when prominent symptom is rhinorrhea

Also known as: Allergodil
Group HPMCGroup ImmunotherapyGroup Placebo

Applied once daily (2 puffs) when no satisfactory therapeutic control from other intranasal treatment

Also known as: Nasonex
Group HPMCGroup ImmunotherapyGroup Placebo

Applied intranasally immediately after every application other intranasal formulation

Also known as: Nasaleze
Group HPMC

Applied intranasally immediately after every application other intranasal formulation

Group Placebo

1 tablet per os - as needed

Also known as: Fortecal
Group HPMCGroup ImmunotherapyGroup Placebo

Per os - if needed (only in case of broncial obstruction)

Group HPMCGroup ImmunotherapyGroup Placebo

Eligibility Criteria

Age18 Years - 55 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Male or female patients
  • Age ≥ 18 and ≤ 55 years
  • Personal history of rhinitis during the pollen season
  • Moderately severe / severe seasonal allergic rhinitis (grass)
  • Positive skin prick test for grass/cereals

You may not qualify if:

  • Subjects with arterial hypertension, arrhythmia or evidence of heart ischemia
  • Subjects with other serious chronic comorbidities and bad therapeutic control
  • Subjects with nasal polyposis
  • Any contraindications for xylometazoline
  • Any contraindications for HPMC
  • Any contraindications for azelastine
  • Any contraindications for bilastine
  • Any contraindications for mometasone
  • Any contraindications for prednisolone
  • Subjects unable to give informed consent
  • Pregnant or lactating women

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Medical University Sofia, University Hospital "Alexandrovska", Clinic of Allergy and Asthma

Sofia, 1431, Bulgaria

Location

Related Publications (5)

  • Pfaar O, Demoly P, Gerth van Wijk R, Bonini S, Bousquet J, Canonica GW, Durham SR, Jacobsen L, Malling HJ, Mosges R, Papadopoulos NG, Rak S, Rodriguez del Rio P, Valovirta E, Wahn U, Calderon MA; European Academy of Allergy and Clinical Immunology. Recommendations for the standardization of clinical outcomes used in allergen immunotherapy trials for allergic rhinoconjunctivitis: an EAACI Position Paper. Allergy. 2014 Jul;69(7):854-67. doi: 10.1111/all.12383. Epub 2014 Apr 25.

    PMID: 24761804BACKGROUND
  • Calderon MA, Bernstein DI, Blaiss M, Andersen JS, Nolte H. A comparative analysis of symptom and medication scoring methods used in clinical trials of sublingual immunotherapy for seasonal allergic rhinitis. Clin Exp Allergy. 2014 Oct;44(10):1228-39. doi: 10.1111/cea.12331.

    PMID: 24773171BACKGROUND
  • Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, van Wijk RG, Ohta K, Zuberbier T, Schunemann HJ; Global Allergy and Asthma European Network; Grading of Recommendations Assessment, Development and Evaluation Working Group. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010 Sep;126(3):466-76. doi: 10.1016/j.jaci.2010.06.047.

    PMID: 20816182BACKGROUND
  • Bousquet J, Bachert C, Canonica GW, Casale TB, Cruz AA, Lockey RJ, Zuberbier T; Extended Global Allergy and Asthma European Network, World Allergy Organization and Allergic Rhinitis and its Impact on Asthma Study Group. Unmet needs in severe chronic upper airway disease (SCUAD). J Allergy Clin Immunol. 2009 Sep;124(3):428-33. doi: 10.1016/j.jaci.2009.06.027. Epub 2009 Aug 5.

    PMID: 19660803BACKGROUND
  • Valerieva A, Popov TA, Staevska M, Kralimarkova T, Petkova E, Valerieva E, Mustakov T, Lazarova T, Dimitrov V, Church MK. Effect of micronized cellulose powder on the efficacy of topical oxymetazoline in allergic rhinitis. Allergy Asthma Proc. 2015 Nov-Dec;36(6):e134-9. doi: 10.2500/aap.2015.36.3879. Epub 2015 Jun 29.

    PMID: 26133030BACKGROUND

MeSH Terms

Conditions

Rhinitis, Allergic, Seasonal

Interventions

azelastineMometasone FuroatebilastinePrednisolone

Condition Hierarchy (Ancestors)

Rhinitis, AllergicRhinitisNose DiseasesRespiratory Tract DiseasesRespiratory HypersensitivityOtorhinolaryngologic DiseasesHypersensitivity, ImmediateHypersensitivityImmune System Diseases

Intervention Hierarchy (Ancestors)

PregnadienediolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic CompoundsPregnadienetriols

Study Officials

  • Todor A Popov, MD, PhD

    Medical University of Sofia

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

July 17, 2015

First Posted

September 23, 2015

Study Start

May 1, 2015

Primary Completion

October 1, 2015

Study Completion

December 1, 2015

Last Updated

September 23, 2015

Record last verified: 2015-09

Locations