NCT04267042

Brief Summary

Chronic Rhinosinusitis (CRS) is a common disorder in North America, affecting more than 31 million people annually. Common therapy for CRS includes intranasal corticosteroids (INCS) such as budesonide. At our centre , the current practice is to administer budesonide two ways: the mucosal atomization device (MAD), which is a nasal spray or impregnated budesonide in nasal saline irrigation (INSI), which is a nasal rinse. Our study aims to see which method of administering budesonide has the best treatment outcomes after sinus surgery. This study will follow patients over a six-month period of time.

Trial Health

35
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 P75+ for early_phase_1

Timeline
Completed

Started Feb 2020

Shorter than P25 for early_phase_1

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

First Submitted

Initial submission to the registry

January 28, 2020

Completed
6 days until next milestone

Study Start

First participant enrolled

February 3, 2020

Completed
9 days until next milestone

First Posted

Study publicly available on registry

February 12, 2020

Completed
12 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 3, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 3, 2021

Completed
Last Updated

February 12, 2020

Status Verified

February 1, 2020

Enrollment Period

1 year

First QC Date

January 28, 2020

Last Update Submit

February 10, 2020

Conditions

Keywords

BudesonideMADINSICRSAFRSPostoperative

Outcome Measures

Primary Outcomes (2)

  • SNOT-22 questionnaire

    This is a standard of care form that includes 22 questions about symptoms and social/emotional consequences of your nasal disorder. You will be asked to rate your problems as they have been over the past two weeks. Patients will give a score out of 110 with a higher score relating to worse symptoms.

    6 months postoperatively

  • MLK endoscopic scores

    This score is based on the endoscopic assessment of polyps, edema, and discharge and are each given score 0-2. A score of 2 indicates a worse outcome.

    6 months postoperatively

Secondary Outcomes (5)

  • EQ 5D-5L questionnaireand

    6 months postoperatively

  • Sniffin' Sticks Smell tests

    6 months postoperatively

  • Sinus cultures

    6 months postoperatively

  • IgE count

    6 months postoperatively

  • Eosinophil count

    6 months postoperatively

Study Arms (2)

Budesonide via Mucosal Atomization Device (MAD)

ACTIVE COMPARATOR

Patients in this arm will administer budesonide using a mucosal atomization device (MAD, Wolfe-Tory Medical, Salt Lake City, UT) once a day at least 5 times a week for 6 months postoperatively. The MAD atomizes the medication into particles from 30-100 um in size thus increasing the surface area for drug absorption. Budesonide is provided in nebules (1mg/2cc). Patients will place two nebules of budesonide into the MAD syringe.

Drug: BudesonideDevice: Mucosal Atomization Device

Budesonide via nasal saline irrigation (INSI)

ACTIVE COMPARATOR

Patients in this arm will administer impregnated budesonide in nasal saline irrigation (INSI) using a NeilMed squeeze bottle (NeilMed Pharmaceuticals, Santa Rosa, California) once a day at least 5 times a week for 6 months postoperatively. Budesonide is provided in nebules (1mg/2cc).Patients will place two nebules of budesonide into the 240mls of saline.

Drug: BudesonideDevice: NeilMed squeeze bottle for Impregnated Nasal Saline Irrigation

Interventions

Budesonide is a corticosteroid that is commonly used intranasally to treat CRS.

Also known as: Pulmicort
Budesonide via Mucosal Atomization Device (MAD)Budesonide via nasal saline irrigation (INSI)

MAD is a device used as an addition to a syringe to atomize medication to increase area of distribution. It is used to administer budesonide within the nasal passages and sinuses to administer medication for CRS.

Also known as: MAD
Budesonide via Mucosal Atomization Device (MAD)

INSI is delivered using a NeilMed squeeze bottle. It is used to administer budesonide within the nasal passages and sinuses to administer medication for CRS.

Also known as: INSI
Budesonide via nasal saline irrigation (INSI)

Eligibility Criteria

Age19 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients aged between 19 years and above
  • Patients with chronic or recurrent sinusitis (as defined by the American Academy of Otolaryngology) with nasal polyposis or allergic fungal rhinosinusitis
  • Patients with an upcoming primary sinus surgery or a revision sinus surgery
  • Patients being prescribed INCS for the first time following Functional Endoscopic Sinus Surgery (FESS)

You may not qualify if:

  • Individuals unable to understand the purpose, methods and conduct of this study
  • Patients unwilling to provide informed consent
  • Are immuno-compromised, and have impairment in mucociliary function (e.g., cystic fibrosis, Kartagener syndrome)
  • Have autoimmune diseases affecting the upper airway (eg Systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis etc)
  • Have sinonasal tumors
  • Patients with a history of pituitary disease
  • Patients with a known hypersensitivity to cortisol, corticotropin, or cosyntropin
  • Recent use of systemic corticosteroids such as prednisone (within last 3 months)
  • Patients that are not adherent to budesonide via MAD/INSI treatment
  • Patients who are pregnant or breastfeeding

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Allergic Fungal Sinusitis

Interventions

Budesonide

Condition Hierarchy (Ancestors)

MycosesBacterial Infections and MycosesInfectionsRespiratory Tract InfectionsSinusitisParanasal Sinus DiseasesNose DiseasesRespiratory Tract DiseasesRespiratory HypersensitivityOtorhinolaryngologic DiseasesHypersensitivity, ImmediateHypersensitivityImmune System Diseases

Intervention Hierarchy (Ancestors)

PregnenedionesPregnenesPregnanesSteroidsFused-Ring CompoundsPolycyclic Compounds

Study Officials

  • Amin Javer, MD

    The University of British Columbia and St. Paul's Sinus Centre

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
early phase 1
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Clinical Professor

Study Record Dates

First Submitted

January 28, 2020

First Posted

February 12, 2020

Study Start

February 3, 2020

Primary Completion

February 3, 2021

Study Completion

February 3, 2021

Last Updated

February 12, 2020

Record last verified: 2020-02

Data Sharing

IPD Sharing
Will not share

We will publish final outcomes as scientific paper.