Comparison of Daily Mometasone Furoate Nasal Spray Alone Versus a Combination With Montelukast for Treatment of Chronic Rhinosinusitis With Asthma After Functional Endoscopic Sinus Surgery
Comparison of Daily Mometasone Furoate Nasal Spray Alone Versus a Combination With Montelukast for Treatment of Chronic Rhinosinusitis With Asthma After Functional Endoscopic Sinus Surgery: a 9-month Randomized, Open-label, Controlled Study
- objectives. To compare the efficacy and the safety of mometasone furoate nasal spray (MFNS; Nasonex 200μg, daily) alone versus a combination with montelukast (singulair 10mg, daily) in chronic rhinosinusitis (CRS) with asthma after functional endoscopic sinus surgery (FESS) for improvement the clinical control of CRS
- the clinical hypotheses. The investigators hypothesize that postoperative combined montelukast and MFNS can better improve clinical control of CRS concomitant with asthma after FESS compared with MFNS alone.
- study design This study is a 9-month randomized, open-label, controlled interventional study.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Surgery plan
- Pre-operation: Patients enrolled in the study will complete assessment and specimen collection on the first day, then followed by 1 week drug therapy with prednisone (30 mg once daily) and MFNS(200ug, once daily).
- FESS: For patients with no surgical contraindications, FESS will be performed. Bilateral nasal cavities will be filled with swelling sponges postoperatively. The stuffing will be removed on postoperative day 2. The patients will be discharged on day 3 after surgery.
- Other treatment: All patients will receive nasal irrigation (normal saline 500 mg twice daily) from postoperative day 3 until day 30. Asthma will be treated as the guidance of professors from the Department of Respiratory Medicine in the investigators hospital.
Drug treatment phase Three days after the surgery (FESS) described above, all patients will be assigned to the following two groups (30 patients each group) using random numbers generated by statistical software.
- Experimental group: Montelukast (10mg, once daily) and MFNS (200μg, once daily) for 6 months
- Control group: MFNS (200μg, once daily) for 6 months
Follow up After the 6-month drug treatment phase, there are still a 3-month follow-up. Totally, there are 5 visits after FESS surgery.
- Visit 1: baseline
- Visit 2: Day 31 post-FESS
- Visit 3: Day 61 post-FESS
- Visit 4: Day 91 post-FESS
- Visit 5: Day 181 post-FESS
- Visit 6: Day 271 post-FESS
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Guangdong
-
Guangzhou, Guangdong, China, 510080
- The First Affiliated Hospital, Sun Yat-sen University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosis of chronic rhinosinusitis according to European position paper of rhinosinusitis and nasal polyps 2007
- Diagnosis of asthma based on Global initiative for asthma 2012
- All patients should provide informed consent prior to the study and agree to follow-up appointments.
Exclusion Criteria:
- Immunodeficiency diseases, history of head and/or facial trauma, cancer or organ transplant recipients.
- Pregnancy or lactation.
- Uncontrolled bronchial asthma.
- Acute respiratory tract infection within one month before the study.
- Use of leukotriene receptor antagonist within 3 months before the enrollment.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: mometasone furoate nasal spray
mometasone furoate nasal spray,200ug qd, 6 months
|
Other Names:
|
|
Experimental: mometasone furoate nasal spray combined with montelukast
montelukast tablet,10mg,qd + mometasone furoate nasal spray, 200ug qd,6 months
|
Other Names:
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percentage of Participants with Decrease in Nasal symptome Visual Analogue Scale (VAS)
Time Frame: 9 months
|
nasal symptoms include general symptom, congestion, rhinorrhea, olfactory loss and headache.
|
9 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percentage of Participants with Decrease in nasal endoscopy score (Lund-Kennedy score)
Time Frame: 9 months
|
Visit 1: baseline Visit 2:Day 31 post-FESS Visit 3: Day 61 post-FESS Visit 4: Day 91 post-FESS Visit 5: Day 181 post-FESS Visit 6: Day 271 post-FESS
|
9 months
|
|
Percentage of Participants with Decrease in sinus CT score (Lund-Mackay, scoring system)
Time Frame: 6 months
|
baseline, 6 months post-FESS
|
6 months
|
|
Percentage of Participants with Increase in Asthma Control test (ACT)
Time Frame: 9 months
|
Visit 1: baseline Visit 2:Day 31 post-FESS Visit 3: Day 61 post-FESS Visit 4: Day 91 post-FESS Visit 5: Day 181 post-FESS Visit 6: Day 271 post-FESS
|
9 months
|
|
Number of Participants with Serious and Non-Serious Adverse Events
Time Frame: 9 months
|
Visit 1: baseline Visit 2:Day 31 post-FESS Visit 3: Day 61 post-FESS Visit 4: Day 91 post-FESS Visit 5: Day 181 post-FESS Visit 6: Day 271 post-FESS
|
9 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Jianbo Shi, doctor, Ent department, the first affiliated hospital, Sun Yat-sen University
Publications and helpful links
General Publications
- Hong H, Chen F, Sun Y, Yang Q, Gao W, Cao Y, Fan Y, Shi J, Li H. Nasal IL-25 predicts the response to oral corticosteroids in chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2018 May;141(5):1890-1892. doi: 10.1016/j.jaci.2017.10.050. Epub 2018 Jan 11. No abstract available.
- Chen F, Hong H, Sun Y, Hu X, Zhang J, Xu G, Zhao W, Li H, Shi J. Nasal interleukin 25 as a novel biomarker for patients with chronic rhinosinusitis with nasal polyps and airway hypersensitiveness: A pilot study. Ann Allergy Asthma Immunol. 2017 Oct;119(4):310-316.e2. doi: 10.1016/j.anai.2017.07.012. Epub 2017 Sep 1.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Infections
- Respiratory Tract Infections
- Respiratory Tract Diseases
- Immune System Diseases
- Lung Diseases
- Hypersensitivity, Immediate
- Bronchial Diseases
- Otorhinolaryngologic Diseases
- Pathological Conditions, Anatomical
- Lung Diseases, Obstructive
- Respiratory Hypersensitivity
- Hypersensitivity
- Paranasal Sinus Diseases
- Nose Diseases
- Polyps
- Asthma
- Sinusitis
- Nasal Polyps
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Inflammatory Agents
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Dermatologic Agents
- Anti-Asthmatic Agents
- Respiratory System Agents
- Leukotriene Antagonists
- Hormone Antagonists
- Cytochrome P-450 CYP1A2 Inducers
- Cytochrome P-450 Enzyme Inducers
- Anti-Allergic Agents
- Montelukast
- Mometasone Furoate
Other Study ID Numbers
Other Study ID Numbers
- 20140329
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