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, J Allergy Clin Immunol. , 127(4):927-34
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.
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