Hypertonic Versus Isotonic Saline Irrigations for Chronic Rhinosinusitis

NCT ID: NCT04242368

Last Updated: 2021-03-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE2/PHASE3

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-01

Study Completion Date

2021-07-01

Brief Summary

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The study aims to determine the safety and efficacy of buffered hypertonic (1.8%) saline nasal rinses as compared to isotonic saline nasal rinses in patients with chronic rhinosinusitis (CRS). Evidence from basic science research suggests that hypertonic solutions may have beneficial effects over isotonic saline rinses; however prior clinical studies on this topic have been inconclusive and limited due to highly variable inclusion criteria, large variability in the volume and concentration of irrigation solution, and inconsistent outcome measures. The goal of the study is to utilize a cross over study design to directly compare the impact of two different types of saline irrigation.

Primary aim:

Compare the efficacy of buffered hypertonic saline irrigations to buffered isotonic saline irrigations on patient reported outcome measures of chronic rhinosinusitis symptoms and nasal obstruction in patients with CRS. Based on in vivo data and prior clinical studies, the investigators expect participants will experience greater symptom improvement with hypertonic saline rinses as compared to isotonic saline irrigations.

Hypothesis: Participants will have greater improvement in patient reported outcome measures (SNOT-22 and NOSE) when using buffered hypertonic sinus irrigations as compared to buffered isotonic saline irrigations.

Detailed Description

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Conditions

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Chronic Rhinosinusitis (Diagnosis)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Isotonic rinse, then hypertonic rinse

Participants will start with a one week washout period without rinses. Then they will complete twice daily sinus rinses isotonic saline for two weeks. Next they will have a one week washout period without rinses. Then they will cross-over and complete hypertonic saline sinus rinses for two weeks. Participants will maintain fluticasone treatment throughout the study.

Group Type ACTIVE_COMPARATOR

Isotonic saline

Intervention Type DRUG

Nasal isotonic saline irrigation (240 mL, 0.9% NaCl) administered through nasal rinse bottle.

Hypertonic Nasal Wash

Intervention Type DRUG

Nasal hypertonic saline irrigation (240 mL, 1.8% NaCl) administered through nasal rinse bottle.

Fluticasone Propionate

Intervention Type DRUG

Fluticasone nasal spray administered two sprays to each nare twice a day

Hypertonic rinse, then isotonic rinse

Participants will start with a one week washout period without rinses. Then they will complete twice daily sinus rinses of hypertonic saline for two weeks. Next they will have a one week washout period without rinses. Then they will cross-over and complete isotonic saline sinus rinses for two weeks. Participants will maintain fluticasone treatment throughout the study.

Fluticasone propionate nasal spray - two sprays to each nare twice a day used for the entire study duration

Group Type EXPERIMENTAL

Isotonic saline

Intervention Type DRUG

Nasal isotonic saline irrigation (240 mL, 0.9% NaCl) administered through nasal rinse bottle.

Hypertonic Nasal Wash

Intervention Type DRUG

Nasal hypertonic saline irrigation (240 mL, 1.8% NaCl) administered through nasal rinse bottle.

Fluticasone Propionate

Intervention Type DRUG

Fluticasone nasal spray administered two sprays to each nare twice a day

Interventions

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Isotonic saline

Nasal isotonic saline irrigation (240 mL, 0.9% NaCl) administered through nasal rinse bottle.

Intervention Type DRUG

Hypertonic Nasal Wash

Nasal hypertonic saline irrigation (240 mL, 1.8% NaCl) administered through nasal rinse bottle.

Intervention Type DRUG

Fluticasone Propionate

Fluticasone nasal spray administered two sprays to each nare twice a day

Intervention Type DRUG

Other Intervention Names

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Flonase

Eligibility Criteria

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Inclusion Criteria

1. Diagnosis of chronic rhinosinusitis with or without polyposis based on the criteria outlined in the American Academy of Otolaryngology-Head and Neck Surgery's Clinical Practice Guideline
2. SNOT-22 score \>/= 20

Exclusion Criteria

1. Sinus surgery within 30 days of beginning the study
2. Oral steroid use within two weeks of study initiation
3. Active sinus exacerbation or sinus exacerbation within two weeks of starting the study
4. Allergies or contraindications to fluticasone nasal spray
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Neelaysh Vukkadala

Resident Physician, Department of Otolaryngology - Head and Neck Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Neelaysh Vukkadala, MD

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Locations

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Stanford University

Stanford, California, United States

Site Status

Countries

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United States

Other Identifiers

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IRB-53836

Identifier Type: -

Identifier Source: org_study_id

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