Study Of Allergic Rhinitis In Patients Who Also Have Asthma

NCT ID: NCT00296491

Last Updated: 2016-12-16

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE4
• Total Enrollment: 725 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2005-09-30
• Study Completion Date: 2007-10-31

Brief Summary

This study will last up to 6 weeks. Subjects will visit the clinic up to 5 times. Certain clinic visits will include a physical examination, medical history review, and lung function tests. All study related medications and medical examinations will be provided at no cost to the subject. The drugs used in this study are approved for the age group under study.

Detailed Description

A Multicenter, Randomized, Double-Blind, Triple-Dummy, Placebo-Controlled, Parallel Group, Four-Week Study Assessing the Efficacy of Fluticasone Propionate Aqueous Nasal Spray 200mcg QD versus Montelukast 10mg QD in Adolescent and Adult Subjects with Asthma and Seasonal Allergic Rhinitis Who are Receiving ADVAIR DISKUS® 100/50mcg BID or Placebo BID

Conditions

Asthma

Keywords

Allergic Rhinitis; Asthma

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Fluticasone Propionate/Salmeterol/Montelukast (FSC+MON)

Fluticasone propionate/salmeterol DISKUS combination product (FSC) twice daily (BID) plus vehicle placebo nasal spray once daily (QD) plus montelukast capsule 10mg (MON) QD

Group Type: ACTIVE_COMPARATOR

fluticasone propionate/salmeterol (FSC)

Intervention Type: DRUG

fluticasone propionate/salmeterol DISKUS combination

montelukast (MON)

Intervention Type: DRUG

montelukast capsule

placebo nasal

Intervention Type: DRUG

vehicle placebo nasal spray

ADVAIR DISKUS

Intervention Type: DRUG

ADVAIR DISKUS

Fluticasone Propionate/Salmeterol (FSC)

FSC BID plus vehicle placebo nasal spray QD plus placebo capsule QD

Group Type: ACTIVE_COMPARATOR

fluticasone propionate/salmeterol (FSC)

Intervention Type: DRUG

fluticasone propionate/salmeterol DISKUS combination

placebo nasal

Intervention Type: DRUG

vehicle placebo nasal spray

ADVAIR DISKUS

Intervention Type: DRUG

ADVAIR DISKUS

placebo capsule

Intervention Type: DRUG

placebo capsule

Fluticasone Prop/Salmeterol/Flut Prop Nasal Spray (FSC+FPANS)

Fluticasone propionate/salmeterol DISKUS combination product (FSC)100/50mcg BID plus fluticasone propionate aqueous nasal spray 200mcg (FPANS) QD plus placebo capsule QD

Group Type: ACTIVE_COMPARATOR

fluticasone propionate/salmeterol (FSC)

Intervention Type: DRUG

fluticasone propionate/salmeterol DISKUS combination

fluticasone propionate (FP)

Intervention Type: DRUG

fluticasone propionate aqueous nasal spray

ADVAIR DISKUS

Intervention Type: DRUG

ADVAIR DISKUS

placebo capsule

Intervention Type: DRUG

placebo capsule

Montelukast (MON)

Placebo DISKUS BID plus vehicle placebo nasal spray QD plus MON QD

Group Type: ACTIVE_COMPARATOR

montelukast (MON)

Intervention Type: DRUG

montelukast capsule

placebo nasal

Intervention Type: DRUG

vehicle placebo nasal spray

placebo DISKUS

Intervention Type: DRUG

placebo DISKUS

Interventions

fluticasone propionate/salmeterol (FSC)

fluticasone propionate/salmeterol DISKUS combination

Intervention Type: DRUG

montelukast (MON)

montelukast capsule

Intervention Type: DRUG

fluticasone propionate (FP)

fluticasone propionate aqueous nasal spray

Intervention Type: DRUG

placebo nasal

vehicle placebo nasal spray

Intervention Type: DRUG

ADVAIR DISKUS

ADVAIR DISKUS

Intervention Type: DRUG

placebo capsule

placebo capsule

Intervention Type: DRUG

placebo DISKUS

placebo DISKUS

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

A subject will be considered eligible for inclusion in this study only if all of the following criteria apply:

• Consent: A signed and dated written informed consent must be obtained from the subject or subject's legally acceptable representative prior to study participation. An informed consent must be signed prior to any change in the subject's medication regimen, including withholding medications prior to Visit 1.
• Gender: Male or female. Females are eligible to participate only if they are currently not pregnant and not lactating. Females of child-bearing potential will be required to use a highly effective method for avoiding pregnancy (i.e., contraception with a failure rate of <1% per year). Female subjects of child-bearing potential will undergo a urine pregnancy test at Visits 1, 2, 3, and 4. Any female who becomes pregnant during the study will be withdrawn. Female subjects should not be enrolled if they plan to become pregnant during the time of study participation.
• Age: 15 years and older.
• Asthma Diagnosis: A diagnosis of persistent asthma, for at least three months, as defined by the following American Thoracic Society definition:

Asthma is a clinical syndrome characterized by increased responsiveness of the tracheobronchial tree to a variety of stimuli. The major symptoms of asthma are paroxysms of dyspnea, wheezing, and cough, which may vary from mild and almost undetectable to severe and unremitting (status asthmaticus). The primary physiological manifestation of this hyperresponsiveness is variable airway obstruction. This can take the form of spontaneous fluctuations in the severity of obstruction, substantial improvements in the severity of obstruction following bronchodilators or corticosteroids, or increased obstruction caused by drugs or other stimuli [American Thoracic Society, 1987a].

NOTE: Intermittent and seasonal asthma, as well as exercise-induced bronchospasm alone, are excluded.

• Asthma Therapy: 3 months' prior and current use of one of the following asthma therapies, with no change in regimen during the month prior to Visit 1:

• Scheduled or as-needed inhaled or oral short-acting beta2-agonist (SABA). Subjects must be able to replace their current short-acting beta2-agonist with albuterol/salbutamol, to be used only on an as-needed basis for the duration of the study.
• Allowed non-corticosteroid controller therapy (e.g., anticholinergics and cromolyn).
• One of the following inhaled corticosteroids taken at the corresponding daily dose:

criteria.

Inhaled Corticosteroid (Total Daily Dose) Beclomethasone dipropionate (≤420mcg) Beclomethasone dipropionate HFA (≤240mcg) Budesonide (≤400mcg) Flunisolide (≤1000mcg) Fluticasone propionate inhalation aerosol (≤220mcg) Fluticasone propionate inhalation powder (≤250mcg) Mometasone furoate (≤220mcg) Triamcinolone acetonide (≤1000mcg) Subjects taking ADVAIR 100/50mcg BID are eligible to replace ADVAIR with FLOVENT HFA 110mcg BID for 14 days prior to Visit 1. This change will be at the Investigator's clinical discretion, taking each individual's current and past asthma stability into account. The subject must be aware of the risks and benefits of switching their medication and acknowledge this by signing an informed consent prior to any change in the subject's medication regimen.

• Asthma Severity: An FEV1 between 65% - 95% of predicted value at Visit 1 after withholding asthma medications as detailed in the protocol.

At Visit 2, subjects must also be experiencing minimum asthma symptoms as defined in Section 5.2.3, "Randomization Criteria", and in Section 6.2 of the protocol.

Predicted FEV1 will be based on the National Health and Nutrition Examination Survey (NHANES III) predicted normal values [Hankinson, 1999].

• Rhinitis Diagnosis: A diagnosis of seasonal allergic rhinitis defined as follows:

• A clinical history (written or verbal confirmation) of allergic rhinitis with the seasonal onset and offset of nasal allergy symptoms during each of the previous 2 relevant allergy seasons (captured in source documents only).

AND •A positive skin test reaction to a geographically relevant seasonal allergen, as determined by the skin prick method, within 24 months prior to or at Visit 1.

For the purposes of this study, a positive skin test reaction is defined as a wheal diameter that is at least 3mm greater than diluent control using 1:20 W:V glycerinated solution.

•At Visit 2, subjects must also be experiencing minimum rhinitis symptoms as defined in Section 5.2.3, "Randomization Criteria", and in Section 6.2 of the protocol.

• Geographical Location: Active residence within a geographical region where exposure to a relevant seasonal allergen is expected to be significant during the entire study period.

Note: The principal investigator is responsible for tracking and recording pollen counts for geographically relevant seasonal allergens throughout the entire study. Alternatively, this information may be obtained from a reputable source from within the same geographical area.

Exclusion Criteria

A subject will not be eligible for inclusion in this study if any of the following criteria apply:

• Currently Diagnosed with Life-Threatening Asthma: An episode or episodes of asthma requiring intubation associated with hypercapnia, respiratory arrest, or hypoxic seizures.
• Asthma Instability: Hospitalization for asthma within 6 months of Visit 1.
• Concurrent Respiratory Disease: Current evidence of pneumonia, pneumothorax, atelectasis, pulmonary fibrotic disease, chronic bronchitis, emphysema, or any other respiratory abnormalities other than asthma.
• Nasal Obstruction: Severe physical obstruction of the nose (e.g., deviated septum) that could affect the deposition of double-blind intranasal study drug.
• Nasal History: History of nasal septal perforation or recent nasal septal surgery.
• Other Concurrent Conditions/Diseases: Any evidence of rhinitis medicamentosa, history of glaucoma and/or cataracts or ocular herpes simplex, or any clinically significant, uncontrolled condition or disease state that, in the opinion of the investigator, would put the safety of the subject at risk through study participation or would confound the interpretation of the results if the condition/disease exacerbated during the study.

The list of additional excluded conditions/diseases includes, but is not limited to: cardiac arrhythmias; congestive heart failure; coronary artery disease; poorly controlled diabetes, poorly controlled hypertension, poorly controlled peptic ulcer, hematologic, hepatic, or renal disease; immunologic compromise; current malignancy; current or quiescent tuberculosis, and Cushing's or Addison's disease.

• Drug Allergy: Any immediate or delayed hypersensitivity to any beta2-agonist, sympathomimetic drug, leukotriene modifier, or any intranasal, inhaled, or systemic corticosteroid therapy, or sensitivity to aspirin or other NSAIDS. Subjects with severe milk protein allergies are also excluded from participation.
• Respiratory Tract Infections: Any sinus, middle ear, oropharyngeal, upper or lower respiratory tract infection that has not resolved at least 14 days immediately preceding Visit 1, or for which antibiotic therapy has not been completed at least 14 days prior to Visit 1.
• Concurrent Medications: Concurrent use of any of the following medications that may affect the course of asthma, rhinitis, or interact with sympathomimetic amines or montelukast.

• Beta-blockers
• tricyclic antidepressants
• monoamine oxidase inhibitors
• phenobarbital
• rifampin
• ritonavir
• ketoconazole
• Systemic Corticosteroids: Use of oral or parenteral systemic corticosteroids within 28 days of Visit 1, or requirement for more than two courses of parenteral systemic corticosteroids for asthma within 6 months of Visit 1.

NOTE: Topical hydrocortisone cream or ointment (1% or less) is permitted during the study.

• Excluded Rhinitis Medications: The following rhinitis medications must be withheld during the corresponding "exclusion period" prior to Visit 1 and are not allowed any time during the study, unless dispensed as double-blind study drug:

Medication (Exclusion Period Prior to Visit 1) Intranasal and ocular corticosteroids (28 days) Leukotriene modifiers (e.g., Singulair, Accolate, Zyflo) (28 days) Intranasal and ocular cromolyn (14 days) Long-acting antihistamines (e.g., loratadine, cetirizine) (10 days) Short-acting antihistamines (includes prescription and OTC) (72 hours) Oral and intranasal decongestants (72 hours) Intranasal anticholinergics (e.g., Atrovent) (24 hours)

• Excluded Asthma Medications: The following asthma medications must be withheld during the corresponding "exclusion period" prior to Visit 1.

These asthma medications, with the exception of an inhaled corticosteroid/long-acting beta2-agonist combination product and Xolair, may be continued during the run-in period of the study (between Visits 1 and 2), but must be withheld prior to Visit 2 for the appropriate "exclusion period" as shown below.

These asthma medications are not allowed any time after randomization at Visit 2 (with the exception of as as-needed rescue albuterol/salbutamol), unless dispensed as double-blind study drug:

Medicationª (Exclusion Period Prior to Visit 1 and/or Visit 2) Inhaled corticosteroid/long-acting beta2-agonist combination product (e.g., ADVAIR) (14 days) Inhaled anticholinergics (e.g., Atrovent, Combivent, Spiriva) (24 hours) Theophylline products (48 hours) Inhaled cromolyn or nedocromil (24 hours) Inhaled corticosteroids (12 hours) Long-acting beta2-agonists (e.g., Foradil, SEREVENT™) (14 days) Oral beta2-agonists (12 hours) Inhaled short-acting beta2-agonists^b (e.g., Proventil) (6 hours) Xolair (12 months)

1. For the leukotriene modifier "exclusion period" prior to Visit 1, refer to Exclusion Criterion 11.

2. Replaced at Visit 1 with albuterol/salbutamol.

• Ophthalmic preparations: Use of artificial tears, eyewashes, homeopathic preparations, irrigation solutions, lubricants, sympathomimetic preparations, vasoconstrictors, or combinations of any of the aforementioned products during the study.
• Immunosuppressive Medications: Use of immunosuppressive medications during the study.

NOTE: Immunotherapy for the treatment of allergies is allowed during the study, provided that it was not initiated within 30 days of Visit 1, the dose has remained fixed over the 30 days prior to Visit 1, and the dose will remain fixed for the duration of the study.

• Positive Pregnancy Test: A positive pregnancy test at Visit 1.
• Tobacco Use: Greater than a 10 pack-year history of cigarette smoking or use of any tobacco products within 1 year of Visit 1. This includes cigarettes, cigars, pipe, chewing tobacco, and snuff.

Note: Pack years = number of cigarettes smoked per day divided by 20, multiplied by the number of years of smoking.

• Questionable Validity of Consent: Any infirmity or disability that would limit the subject's consent or geographic location that would limit the compliance for scheduled visits.
• Investigational Medications: Use of any investigational drug within 30 days of Visit 1.
• 3rd shift/Nighttime employment: Any employment during the nighttime hours (10 p.m. - 6 a.m.) or 3rd shift.
• Site affiliation: Participation of anyone associated with the administration of the study or their immediate family members

• Minimum Eligible Age: 15 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

GlaxoSmithKline

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

GSK Clinical Trials

Role: STUDY_DIRECTOR

GlaxoSmithKline

Locations

GSK Investigational Site

Birmingham, Alabama, United States

GSK Investigational Site

Glendale, Arizona, United States

GSK Investigational Site

Scottsdale, Arizona, United States

GSK Investigational Site

Tucson, Arizona, United States

GSK Investigational Site

Hot Springs, Arkansas, United States

GSK Investigational Site

Berkeley, California, United States

GSK Investigational Site

Huntington Beach, California, United States

GSK Investigational Site

Long Beach, California, United States

GSK Investigational Site

Los Angeles, California, United States

GSK Investigational Site

Rancho Mirage, California, United States

GSK Investigational Site

Riverside, California, United States

GSK Investigational Site

Roseville, California, United States

GSK Investigational Site

San Diego, California, United States

GSK Investigational Site

San Diego, California, United States

GSK Investigational Site

San Jose, California, United States

GSK Investigational Site

San Jose, California, United States

GSK Investigational Site

Stockton, California, United States

GSK Investigational Site

Vista, California, United States

GSK Investigational Site

Boulder, Colorado, United States

GSK Investigational Site

Colorado Springs, Colorado, United States

GSK Investigational Site

Fort Collins, Colorado, United States

GSK Investigational Site

Lakewood, Colorado, United States

GSK Investigational Site

Brandon, Florida, United States

GSK Investigational Site

Coral Gables, Florida, United States

GSK Investigational Site

Ocala, Florida, United States

GSK Investigational Site

Pensacola, Florida, United States

GSK Investigational Site

Tallahassee, Florida, United States

GSK Investigational Site

Albany, Georgia, United States

GSK Investigational Site

Atlanta, Georgia, United States

GSK Investigational Site

Columbus, Georgia, United States

GSK Investigational Site

Gainesville, Georgia, United States

GSK Investigational Site

Lawrenceville, Georgia, United States

GSK Investigational Site

Savannah, Georgia, United States

GSK Investigational Site

Savannah, Georgia, United States

GSK Investigational Site

Chicago, Illinois, United States

GSK Investigational Site

Springfield, Illinois, United States

GSK Investigational Site

Indianapolis, Indiana, United States

GSK Investigational Site

South Bend, Indiana, United States

GSK Investigational Site

Iowa City, Iowa, United States

GSK Investigational Site

Overland Park, Kansas, United States

GSK Investigational Site

Lexington, Kentucky, United States

GSK Investigational Site

Louisville, Kentucky, United States

GSK Investigational Site

Owensboro, Kentucky, United States

GSK Investigational Site

Baton Rouge, Louisiana, United States

GSK Investigational Site

Covington, Louisiana, United States

GSK Investigational Site

Lafayette, Louisiana, United States

GSK Investigational Site

Shreveport, Louisiana, United States

GSK Investigational Site

Sunset, Louisiana, United States

GSK Investigational Site

Baltimore, Maryland, United States

GSK Investigational Site

North Andover, Massachusetts, United States

GSK Investigational Site

Minneapolis, Minnesota, United States

GSK Investigational Site

Jackson, Mississippi, United States

GSK Investigational Site

Jefferson City, Missouri, United States

GSK Investigational Site

Rolla, Missouri, United States

GSK Investigational Site

St Louis, Missouri, United States

GSK Investigational Site

Warrensburg, Missouri, United States

GSK Investigational Site

Lincoln, Nebraska, United States

GSK Investigational Site

Omaha, Nebraska, United States

GSK Investigational Site

Omaha, Nebraska, United States

GSK Investigational Site

Omaha, Nebraska, United States

GSK Investigational Site

Papillion, Nebraska, United States

GSK Investigational Site

Forked River, New Jersey, United States

GSK Investigational Site

Summit, New Jersey, United States

GSK Investigational Site

Rochester, New York, United States

GSK Investigational Site

Asheville, North Carolina, United States

GSK Investigational Site

Raleigh, North Carolina, United States

GSK Investigational Site

Canton, Ohio, United States

GSK Investigational Site

Cincinnati, Ohio, United States

GSK Investigational Site

Parma, Ohio, United States

GSK Investigational Site

Oklahoma City, Oklahoma, United States

GSK Investigational Site

Bend, Oregon, United States

GSK Investigational Site

Portland, Oregon, United States

GSK Investigational Site

Pittsburgh, Pennsylvania, United States

GSK Investigational Site

Upland, Pennsylvania, United States

GSK Investigational Site

Providence, Rhode Island, United States

GSK Investigational Site

Charleston, South Carolina, United States

GSK Investigational Site

Charleston, South Carolina, United States

GSK Investigational Site

Greenville, South Carolina, United States

GSK Investigational Site

Orangeburg, South Carolina, United States

GSK Investigational Site

Simpsonville, South Carolina, United States

GSK Investigational Site

Spartanburg, South Carolina, United States

GSK Investigational Site

Chattanooga, Tennessee, United States

GSK Investigational Site

Germantown, Tennessee, United States

GSK Investigational Site

Knoxville, Tennessee, United States

GSK Investigational Site

Savannah, Tennessee, United States

GSK Investigational Site

Austin, Texas, United States

GSK Investigational Site

Dallas, Texas, United States

GSK Investigational Site

Dallas, Texas, United States

GSK Investigational Site

Dallas, Texas, United States

GSK Investigational Site

Dallas, Texas, United States

GSK Investigational Site

El Paso, Texas, United States

GSK Investigational Site

El Paso, Texas, United States

GSK Investigational Site

Houston, Texas, United States

GSK Investigational Site

Houston, Texas, United States

GSK Investigational Site

Kerrville, Texas, United States

GSK Investigational Site

San Antonio, Texas, United States

GSK Investigational Site

San Antonio, Texas, United States

GSK Investigational Site

San Antonio, Texas, United States

GSK Investigational Site

Waco, Texas, United States

GSK Investigational Site

Salt Lake City, Utah, United States

GSK Investigational Site

West Jordan, Utah, United States

GSK Investigational Site

Danville, Virginia, United States

GSK Investigational Site

Richmond, Virginia, United States

GSK Investigational Site

Kirkland, Washington, United States

GSK Investigational Site

Winnipeg, Manitoba, Canada

GSK Investigational Site

Ajax, Ontario, Canada

GSK Investigational Site

Brampton, Ontario, Canada

GSK Investigational Site

Greater Sudbury, Ontario, Canada

GSK Investigational Site

Kanata, Ontario, Canada

GSK Investigational Site

Mississauga, Ontario, Canada

GSK Investigational Site

Niagara Falls, Ontario, Canada

GSK Investigational Site

Ottawa, Ontario, Canada

GSK Investigational Site

Ottawa, Ontario, Canada

GSK Investigational Site

Québec, Quebec, Canada

GSK Investigational Site

Trois-Rivières, Quebec, Canada

GSK Investigational Site

Tallinn, , Estonia

GSK Investigational Site

Tartu, , Estonia

GSK Investigational Site

Bialystok, , Poland

GSK Investigational Site

Bialystok, , Poland

GSK Investigational Site

Krakow, , Poland

GSK Investigational Site

Lodz, , Poland

Countries

United States; Canada; Estonia; Poland

References

Katial RK, Oppenheimer JJ, Ostrom NK, Mosnaim GS, Yancey SW, Waitkus-Edwards KR, Prillaman BA, Ortega HG. Adding montelukast to fluticasone propionate/salmeterol for control of asthma and seasonal allergic rhinitis. Allergy Asthma Proc. 2010 Jan-Feb;31(1):68-75. doi: 10.2500/aap.2010.31.3306.

Reference Type: DERIVED

PMID: 20167147 (View on PubMed)

Study Documents

Document Type: Informed Consent Form

View Document

Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Dataset Specification

View Document

Document Type: Clinical Study Report

View Document

Document Type: Individual Participant Data Set

View Document

Document Type: Annotated Case Report Form

View Document

Related Links

https://www.clinicalstudydatarequest.com

Researchers can use this site to request access to anonymised patient level data and/or supporting documents from clinical studies to conduct further research.

Other Identifiers

ADA103575

Identifier Type: -

Identifier Source: org_study_id