Effect of Veramyst and Olopatadine 0.2% Opthalmic Solution Alone and In Combination on the Nasal and Ocular Symptoms of the Early Reaction to Nasal Challenge With Allergen.
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 21
- 试验地点
- 1
- 主要终点
- Total Eye Symptoms Score Difference
研究概览
简要总结
People who have hayfever or allergic rhinitis often complain about eye symptoms associated with their nasal symptoms. How people with hayfever develop eye symptoms is not clear. The purpose of this study is to better understand the generation of eye symptoms in patients with allergic rhinitis. We have previously shown that placing the substance that subjects are allergic to in their nose causes both nose and eye symptoms. This can be explain by a parasympathetic neurogenic reflex from the nose to the eye. Such a reflex would readily explain the tearing and watery eye symptoms, but does not explain the itch. In this study, we are going to address one possible explanation for the itch; does an axonal neurogenic reflex stimulate mast cells in the eye to release histamine, which then causes the itch? We will do this by placing an antihistamine drop in the eye and challenge the nose with allergen. We will also attempt to demonstrate that mast activation isn't effected by blocking the initiating of the reflex with a nasal steroid, as done in our previous study, and showing that the addition of an antihistamine does not add to the reduction of symptoms.
详细描述
We performed a randomized, double-blind, double-dummy, placebo-controlled, four-way crossover study in 21 subjects with seasonal allergic rhinitis studied out of season. Healthy patients, between 18 and 50 years of age, came to the Nasal Physiology Laboratory at The University of Chicago for screening, where they completed an allergy questionnaire and underwent skin puncture testing for confirmation of allergy to grass or ragweed. Female subjects were given pregnancy tests. Patients who were eligible then underwent a screening nasal challenge with either grass or ragweed allergen depending on their skin test results and history. The study was approved by the Institutional Review Board at The University of Chicago and all of the patients gave written informed consent before entry.
After a 2-week washout period, after the screening challenge, 21 subjects who had positive screening challenge returned to the Nasal Physiology Laboratory where they were randomized to receive 1 week of one of four treatments:
- placebo (PL) nasal spray and PL eye drops (PL/PL),
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO),
- fluticasone furoate (FF, also known as Veramyst) nasal spray and PL eye drops (FF/PL), and
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO).
Specifically, the PL eye drops used were lubricant eye drops with active ingredients of 0.3% glycerin and 1.0% propylene glycol and the PL nasal spray was provided by GlaxoSmithKline. Treatment with OLO consisted of 1 drop of 0.2% OLO in each eye daily and treatment of FF consisted of 2 puffs in each nostril daily, giving a total of 110 micrograms delivered in each nostril. After a week of each of the treatments, the subjects returned to the Nasal Physiology Laboratory to undergo a nasal challenge. The subjects then returned the next day while still receiving treatment for another nasal challenge to augment the nasal ocular reflex. Next, the patients had a 2-week washout period and then switched over to the next randomized treatment arm. This sequence was repeated until subjects completed all four arms of the trial.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 45 Years(Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Males and females between 18 and 45 years of age.
- •History of grass and/or ragweed allergic rhinitis.
- •Positive skin test to grass and/or ragweed antigen.
- •Positive response to screening nasal challenge.
排除标准
- •Physical signs or symptoms suggestive of renal, hepatic or cardiovascular disease.
- •Pregnant or lactating women.
- •Upper respiratory infection within 14 days of study start.
- •forced expiratory volume at one second (FEV1) <80% of predicted at screening for subjects with history of mild asthma.
研究组 & 干预措施
FF/PL, PL/OLO, FF/OLO, PL/PL
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL)
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO),
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO), and
- placebo (PL) nasal spray and PL eye drops (PL/PL).
干预措施: PL nasal spray (Drug)
FF/PL, PL/OLO, FF/OLO, PL/PL
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL)
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO),
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO), and
- placebo (PL) nasal spray and PL eye drops (PL/PL).
干预措施: fluticasone furoate (FF) (Drug)
FF/PL, PL/OLO, FF/OLO, PL/PL
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL)
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO),
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO), and
- placebo (PL) nasal spray and PL eye drops (PL/PL).
干预措施: PL eye drops (Drug)
FF/PL, PL/OLO, FF/OLO, PL/PL
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL)
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO),
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO), and
- placebo (PL) nasal spray and PL eye drops (PL/PL).
干预措施: olopatadine (OLO) (Drug)
PL/OLO, FF/OLO, PL/PL, FF/PL
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO),
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO),
- placebo (PL) nasal spray and PL eye drops (PL/PL), and
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL).
干预措施: PL nasal spray (Drug)
PL/OLO, FF/OLO, PL/PL, FF/PL
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO),
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO),
- placebo (PL) nasal spray and PL eye drops (PL/PL), and
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL).
干预措施: fluticasone furoate (FF) (Drug)
PL/OLO, FF/OLO, PL/PL, FF/PL
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO),
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO),
- placebo (PL) nasal spray and PL eye drops (PL/PL), and
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL).
干预措施: PL eye drops (Drug)
PL/OLO, FF/OLO, PL/PL, FF/PL
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO),
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO),
- placebo (PL) nasal spray and PL eye drops (PL/PL), and
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL).
干预措施: olopatadine (OLO) (Drug)
FF/OLO, PL/PL, FF/PL, PL/OLO
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO),
- placebo (PL) nasal spray and PL eye drops (PL/PL),
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL), and
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO).
干预措施: PL nasal spray (Drug)
FF/OLO, PL/PL, FF/PL, PL/OLO
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO),
- placebo (PL) nasal spray and PL eye drops (PL/PL),
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL), and
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO).
干预措施: fluticasone furoate (FF) (Drug)
FF/OLO, PL/PL, FF/PL, PL/OLO
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO),
- placebo (PL) nasal spray and PL eye drops (PL/PL),
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL), and
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO).
干预措施: PL eye drops (Drug)
FF/OLO, PL/PL, FF/PL, PL/OLO
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO),
- placebo (PL) nasal spray and PL eye drops (PL/PL),
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL), and
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO).
干预措施: olopatadine (OLO) (Drug)
PL/PL, FF/PL, PL/OLO, FF/OLO
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- placebo (PL) nasal spray and PL eye drops (PL/PL),
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL),
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO), and
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO).
干预措施: PL nasal spray (Drug)
PL/PL, FF/PL, PL/OLO, FF/OLO
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- placebo (PL) nasal spray and PL eye drops (PL/PL),
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL),
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO), and
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO).
干预措施: fluticasone furoate (FF) (Drug)
PL/PL, FF/PL, PL/OLO, FF/OLO
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- placebo (PL) nasal spray and PL eye drops (PL/PL),
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL),
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO), and
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO).
干预措施: PL eye drops (Drug)
PL/PL, FF/PL, PL/OLO, FF/OLO
Each subject received a total of 4 weeks of treatment (1 week per treatment with 2 week washout period between treatments) in the following order:
- placebo (PL) nasal spray and PL eye drops (PL/PL),
- fluticasone furoate (FF) nasal spray and PL eye drops (FF/PL),
- PL nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (PL/OLO), and
- FF nasal spray and olopatadine (OLO) 0.2% ophthalmic solution (FF/OLO).
干预措施: olopatadine (OLO) (Drug)
结局指标
主要结局
Total Eye Symptoms Score Difference
时间窗: 50 minutes [duration of 3 nasal challenges and 2 washout periods]
After treatment, each participant was subjected to a diluent (control) challenge in one eye and was asked to rate 2 eye symptoms (watery and itchy) according to the following scale: 0=none, 1=mild, 2=moderate, 3=severe. The participant was then exposed to 3 doses of an antigen challenge and was asked to similarly rate severity of watery and itchy eye symptoms after each dose. Diluent challenge scores were subtracted from the scores recorded after each dose. This process was repeated in the other eye. The outcome is the total of the score differences (i.e. score after each dose subtracted by diluent challenge score) summed across doses, symptoms (watery and itchy), and eyes (left and right). Thus, each participant's total score is an integer value ranging from -36 to 36.
次要结局
- Total Nasal Symptoms Score Difference(50 minutes [duration of 3 nasal challenges and 2 washout periods])
- Total Number of Sneezes(50 minutes [duration of 3 nasal challenges and 2 washout periods])
- Change in Histamine Level (Across Nasal Challenges)(50 minutes [duration of 3 nasal challenges and 2 washout periods])
- Change in Tryptase Level (Across Nasal Challenges)(50 minutes [duration of 3 nasal challenges and 2 washout periods])
- Total Number of Eosinophils(50 minutes [duration of 3 nasal challenges and 2 washout periods])
研究者
Robert Naclerio
MD
University of Chicago
