Nasal Obstruction With Oxymetazoline and Corticosteroids

NCT ID: NCT06830109

Last Updated: 2025-09-11

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-15

Study Completion Date

2026-12-30

Brief Summary

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This study aims to examine the efficacy and safety of commination oxymetazoline/intranasal steroids for long-term management of chronic nasal obstruction that is recalcitrant to the current standard of care. The investigators hypothesize that combination treatment with oxymetazoline and intranasal corticosteroid spray will provide a larger reduction in nasal obstruction than intranasal corticosteroid alone for patients suffering from chronic nasal obstruction, and there will not be occurrences of rhinitis medicamentosa.

Detailed Description

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Participants will be directed to apply the intranasal spray, at a dosage of two sprays in each nostril, twice daily. The total treatment time for participants in both trial arms is 7 weeks. Participants will be randomized to either 1) oxymetazoline + budesonide intranasal spray or 2) budesonide intranasal spray. Participants will be mailed the intranasal spray directly from the pharmacy. Participants will complete questionnaires via REDCap survey link at baseline, Week 2, Week 4, Week 5, Week 6, and Week 7. A group of 10 participants will be asked to have nasal mucosal biopsies done at baseline and between weeks 4 and 6.

Conditions

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Nasal Obstruction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Single-center, double-blinded, randomized, controlled trial conducted at Washington University School of Medicine
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
The participant and the research team will be unaware of the participant's intervention assignment.

Study Groups

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budesonide + oxymetazoline,

alpha-adrenergic agonist and vasoconstrictor that is available over-the-counter (OTC).

Group Type EXPERIMENTAL

Oxymetazoline Nasal Spray

Intervention Type DRUG

Intra-nasal alpha-adrenergic agonist and vasoconstrictor that is available over-the-counter (OTC)

Budesonide nasal spray

Intervention Type DRUG

Intranasal corticosteroid that is available over-the-counter (OTC)

budesonide

intranasal corticosteroid that is available OTC.

Group Type ACTIVE_COMPARATOR

Budesonide nasal spray

Intervention Type DRUG

Intranasal corticosteroid that is available over-the-counter (OTC)

Interventions

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Oxymetazoline Nasal Spray

Intra-nasal alpha-adrenergic agonist and vasoconstrictor that is available over-the-counter (OTC)

Intervention Type DRUG

Budesonide nasal spray

Intranasal corticosteroid that is available over-the-counter (OTC)

Intervention Type DRUG

Other Intervention Names

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Afrin (commercial name for oxymetazoline hydrochloride) Rhinocort (commercial name for budesonide)

Eligibility Criteria

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Inclusion Criteria

1. males and females ages 18 years or older
2. have a history of nasal obstruction
3. have failed a trial of topical steroids (that included at least 1 month of daily use)
4. ability to read, write, and understand English
5. either do not desire surgery or are poor surgical candidates due to medical comorbidities.
6. Patients who have had prior use of oxymetazoline or other nasal decongestants are eligible for the study but must have stopped usage 4 weeks prior to randomization.

1. Must be willing to stop using any other nasal sprays, besides saline, and oral decongestants.

Exclusion Criteria

1. Any history of sinonasal mass/tumor
2. Any history of nasal polyps
3. a known history of chronic sinusitis
4. an allergy to oxymetazoline
5. or who have any medical contraindication to oxymetazoline use, such as pulmonary hypertension.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Washington University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Nyssa Farrell

Assistant Professor of Otolaryngology-Head & Neck Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nyssa F Farrell, MD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Locations

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Washington University

St Louis, Missouri, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Nyssa Farrell, MD

Role: CONTACT

314-362-7509

Sara Kukuljan

Role: CONTACT

314-362-7563

Facility Contacts

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Sara Kukuljan

Role: primary

314-362-7563

Lucas Cruz, BA

Role: backup

314-362-0549

References

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Scarupa MD, Kaliner MA. Nonallergic rhinitis, with a focus on vasomotor rhinitis: clinical importance, differential diagnosis, and effective treatment recommendations. World Allergy Organ J. 2009 Mar;2(3):20-5. doi: 10.1097/WOX.0b013e3181990aac.

Reference Type BACKGROUND
PMID: 23282951 (View on PubMed)

Stewart M, Ferguson B, Fromer L. Epidemiology and burden of nasal congestion. Int J Gen Med. 2010 Apr 8;3:37-45. doi: 10.2147/ijgm.s8077.

Reference Type BACKGROUND
PMID: 20463822 (View on PubMed)

Thongngarm T, Assanasen P, Pradubpongsa P, Tantilipikorn P. The effectiveness of oxymetazoline plus intranasal steroid in the treatment of chronic rhinitis: A randomised controlled trial. Asian Pac J Allergy Immunol. 2016 Mar;34(1):30-7. doi: 10.12932/AP0649.34.1.2016.

Reference Type BACKGROUND
PMID: 26994623 (View on PubMed)

Calvo-Henriquez C, Viera-Artiles J, Rodriguez-Iglesias M, Rodriguez-Rivas P, Maniaci A, Yanez MM, Martinez-Capoccioni G, Alobid I. The Role of Corticosteroid Nasal Irrigations in the Management of Chronic Rhinosinusitis: A State-of-the-Art Systematic Review. J Clin Med. 2023 May 22;12(10):3605. doi: 10.3390/jcm12103605.

Reference Type BACKGROUND
PMID: 37240711 (View on PubMed)

Vaidyanathan S, Williamson P, Clearie K, Khan F, Lipworth B. Fluticasone reverses oxymetazoline-induced tachyphylaxis of response and rebound congestion. Am J Respir Crit Care Med. 2010 Jul 1;182(1):19-24. doi: 10.1164/rccm.200911-1701OC. Epub 2010 Mar 4.

Reference Type BACKGROUND
PMID: 20203244 (View on PubMed)

Graf P, Juto JE. Decongestion effect and rebound swelling of the nasal mucosa during 4-week use of oxymetazoline. ORL J Otorhinolaryngol Relat Spec. 1994 May-Jun;56(3):157-60. doi: 10.1159/000276633.

Reference Type BACKGROUND
PMID: 7515487 (View on PubMed)

Morris S, Eccles R, Martez SJ, Riker DK, Witek TJ. An evaluation of nasal response following different treatment regimes of oxymetazoline with reference to rebound congestion. Am J Rhinol. 1997 Mar-Apr;11(2):109-15. doi: 10.2500/105065897782537197.

Reference Type BACKGROUND
PMID: 9129752 (View on PubMed)

Kumar RS, Jain MK, Kushwaha JS, Patil S, Patil V, Ghatak S, Sanmukhani J, Mittal R. Efficacy and Safety of Fluticasone Furoate and Oxymetazoline Nasal Spray: A Novel First Fixed Dose Combination for the Management of Allergic Rhinitis with Nasal Congestion. J Asthma Allergy. 2022 Jun 10;15:783-792. doi: 10.2147/JAA.S357288. eCollection 2022.

Reference Type BACKGROUND
PMID: 35712651 (View on PubMed)

Matreja PS, Gupta V, Kaur J, Singh S. Efficacy of fluticasone and oxymetazoline as the treatment for allergic rhinitis. J Clin Diagn Res. 2012;6(1):85-88.

Reference Type BACKGROUND

Meltzer EO, Bernstein DI, Prenner BM, Berger WE, Shekar T, Teper AA. Mometasone furoate nasal spray plus oxymetazoline nasal spray: short-term efficacy and safety in seasonal allergic rhinitis. Am J Rhinol Allergy. 2013 Mar-Apr;27(2):102-8. doi: 10.2500/ajra.2013.27.3864.

Reference Type BACKGROUND
PMID: 23562197 (View on PubMed)

Juvekar MR, Vaidya GK, Majumder A, Pendharkar AD, Irudhayarajan A, Kundu A, Ramesh D, Kumar JD, Jagannatha B, Mathew J, Nikam MP, Mehta M, Chawla N, Hajare P, Gowda PGC, Murthy PVLN, Mathew SM, Damle MV, Kant C, Nair AB, Jaiswal A, Mehta RT. A Real-World Observational Study to Evaluate the Safety and Effectiveness of Fluticasone Furoate-Oxymetazoline Fixed Dose Combination Nasal Spray in Patients with Allergic Rhinitis. Clin Drug Investig. 2024 Feb;44(2):123-130. doi: 10.1007/s40261-023-01338-8. Epub 2024 Jan 9.

Reference Type BACKGROUND
PMID: 38195833 (View on PubMed)

Elwany SS, Stephanos WM. Rhinitis medicamentosa. An experimental histopathological and histochemical study. ORL J Otorhinolaryngol Relat Spec. 1983;45(4):187-94. doi: 10.1159/000275642.

Reference Type BACKGROUND
PMID: 6192384 (View on PubMed)

Elwany S, Abdel-Salaam S. Treatment of rhinitis medicamentosa with fluticasone propionate--an experimental study. Eur Arch Otorhinolaryngol. 2001 Mar;258(3):116-9. doi: 10.1007/s004050000309.

Reference Type BACKGROUND
PMID: 11374251 (View on PubMed)

Knipping S, Holzhausen HJ, Goetze G, Riederer A, Bloching MB. Rhinitis medicamentosa: electron microscopic changes of human nasal mucosa. Otolaryngol Head Neck Surg. 2007 Jan;136(1):57-61. doi: 10.1016/j.otohns.2006.08.025.

Reference Type BACKGROUND
PMID: 17210334 (View on PubMed)

Lin CY, Cheng PH, Fang SY. Mucosal changes in rhinitis medicamentosa. Ann Otol Rhinol Laryngol. 2004 Feb;113(2):147-51. doi: 10.1177/000348940411300213.

Reference Type BACKGROUND
PMID: 14994772 (View on PubMed)

Cam B, Sari M, Midi A, Gergin O. Xylitol treats nasal mucosa in rhinitis medicamentosa: an experimental rat model study. Eur Arch Otorhinolaryngol. 2019 Nov;276(11):3123-3130. doi: 10.1007/s00405-019-05605-3. Epub 2019 Aug 29.

Reference Type BACKGROUND
PMID: 31468129 (View on PubMed)

Suh SH, Chon KM, Min YG, Jeong CH, Hong SH. Effects of topical nasal decongestants on histology of nasal respiratory mucosa in rabbits. Acta Otolaryngol. 1995 Sep;115(5):664-71. doi: 10.3109/00016489509139384.

Reference Type BACKGROUND
PMID: 8928640 (View on PubMed)

Tas A, Yagiz R, Yalcin O, Uzun C, Huseyinova G, Adali MK, Karasalihoglu AR. Use of mometasone furoate aqueous nasal spray in the treatment of rhinitis medicamentosa: an experimental study. Otolaryngol Head Neck Surg. 2005 Apr;132(4):608-12. doi: 10.1016/j.otohns.2005.01.010.

Reference Type BACKGROUND
PMID: 15806055 (View on PubMed)

Busner J, Targum SD. The clinical global impressions scale: applying a research tool in clinical practice. Psychiatry (Edgmont). 2007 Jul;4(7):28-37.

Reference Type BACKGROUND
PMID: 20526405 (View on PubMed)

Tait SD, Kallogjeri D, Chidambaram S, Schneider J, Piccirillo JF. Psychometric and Clinimetric Validity of the Modified 25-Item Sino-Nasal Outcome Test. Am J Rhinol Allergy. 2019 Sep;33(5):577-585. doi: 10.1177/1945892419851622. Epub 2019 May 28. No abstract available.

Reference Type BACKGROUND
PMID: 31134810 (View on PubMed)

Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol. 2009 Oct;34(5):447-54. doi: 10.1111/j.1749-4486.2009.01995.x.

Reference Type BACKGROUND
PMID: 19793277 (View on PubMed)

Lipan MJ, Most SP. Development of a severity classification system for subjective nasal obstruction. JAMA Facial Plast Surg. 2013 Sep-Oct;15(5):358-61. doi: 10.1001/jamafacial.2013.344.

Reference Type BACKGROUND
PMID: 23846399 (View on PubMed)

Taverner D, Bickford L, Shakib S, Tonkin A. Evaluation of the dose-response relationship for intra-nasal oxymetazoline hydrochloride in normal adults. Eur J Clin Pharmacol. 1999 Sep;55(7):509-13. doi: 10.1007/s002280050665.

Reference Type BACKGROUND
PMID: 10501820 (View on PubMed)

Akerlund A, Klint T, Olen L, Rundcrantz H. Nasal decongestant effect of oxymetazoline in the common cold: an objective dose-response study in 106 patients. J Laryngol Otol. 1989 Aug;103(8):743-6. doi: 10.1017/s0022215100109958.

Reference Type BACKGROUND
PMID: 2671220 (View on PubMed)

Druce HM, Ramsey DL, Karnati S, Carr AN. Topical nasal decongestant oxymetazoline (0.05%) provides relief of nasal symptoms for 12 hours. Rhinology. 2018 Dec 1;56(4):343-350. doi: 10.4193/Rhin17.150.

Reference Type BACKGROUND
PMID: 29785414 (View on PubMed)

Saratziotis A, Emanuelli E, Zanotti C, Mireas G, Pavlidis P, Ferfeli M, Hajiioannou J. Endoscopic sinus surgery outcomes in CRS: quality of life and correlations with NOSE scale in a prospective cohort study. Eur Arch Otorhinolaryngol. 2021 Apr;278(4):1059-1066. doi: 10.1007/s00405-020-06334-8. Epub 2020 Sep 8.

Reference Type BACKGROUND
PMID: 32897442 (View on PubMed)

Kandathil CK, Saltychev M, Abdelwahab M, Spataro EA, Moubayed SP, Most SP. Minimal Clinically Important Difference of the Standardized Cosmesis and Health Nasal Outcomes Survey. Aesthet Surg J. 2019 Jul 12;39(8):837-840. doi: 10.1093/asj/sjz070.

Reference Type BACKGROUND
PMID: 30873533 (View on PubMed)

Baroody FM, Brown D, Gavanescu L, DeTineo M, Naclerio RM. Oxymetazoline adds to the effectiveness of fluticasone furoate in the treatment of perennial allergic rhinitis. J Allergy Clin Immunol. 2011 Apr;127(4):927-34. doi: 10.1016/j.jaci.2011.01.037. Epub 2011 Mar 5.

Reference Type BACKGROUND
PMID: 21377716 (View on PubMed)

Other Identifiers

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202406175

Identifier Type: -

Identifier Source: org_study_id

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