Effects of Phenylephrine on Nasal Congestion in Participants With Seasonal Allergic Rhinitis (P08156 AM2)(Completed)

A Randomized, Dose-ranging, Placebo-controlled Trial to Evaluate the Effects of Phenylephrine HCl Immediate Release Tablets on Nasal Congestion in Subjects With Seasonal Allergic Rhinitis

The trial will evaluate the nasal congestion symptom relief of the approved 10 mg phenylephrine (PE) dose and the higher 20 mg, 30 mg, and 40 mg PE doses compared with placebo in participants with histories of seasonal allergic rhinitis, using loratadine as background medication.

Study Overview

• Status: Completed
• Conditions: Rhinitis; Seasonal Rhinitis
• Intervention / Treatment: Drug: Phenylephrine HCl; Drug: Placebo; Drug: Loratadine

• Study Type: Interventional
• Enrollment (Actual): 539
• Phase: Phase 2

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion criteria:

• Female participants of reproductive potential must have a negative pregnancy test and agree to use acceptable methods of birth control throughout the study.
• Participant is willing to stop use of current decongestant and allergy medications during the trial.
• Participant has a documented or self-reported history of seasonal allergy.
• Participant has documented positive skin testing to spring pollen allergens.
• Participant has nasal congestion of at least moderate severity.
• Participant has mean seated (after 5 minutes of rest) systolic/diastolic blood pressure ≤138/88 mmHg.
• Participant has clinically acceptable physical exam and 12-lead electrocardiogram (ECG).
• Participant is without clinically significant disease.
• Participant must agree not to take monoamine oxidase inhibitor (MAOI) from 14 days before trial participation until 14 days after the end of the trial.
• Participant must sign an informed consent form

Exclusion criteria:

• Participants must not have any significant medical condition that is a contraindication to the use of phenylephrine HCl or loratadine, such as thyroid disease, uncontrolled diabetes mellitus, coronary heart disease, ischemic heart disease, elevated intraocular pressure, or prostatic hypertrophy.
• Participants with a history or presence of hypertension.
• Participants who have started allergen immunotherapy within a month preceding enrollment or starting allergen immunotherapy or anticipating immunotherapy dose change during the trial. Xolair (omalizumab) may not be used within 4 years prior to trial participation.
• Participants who have a known allergy or intolerance to phenylephrine HCl, any other decongestant, loratadine, desloratadine, or any other antihistamine.
• Participants with persistent asthma, rhinitis medicamentosa, or acute or chronic sinusitis, or a history of significant sinusitis within one month of enrollment.
• Participant with a history of intermittent asthma may be considered for enrollment provided they have no asthma symptoms at the time of enrollment and use only a short acting beta2-agonist less than twice weekly.
• Participants who have used systemic (oral, rectal, injectable), topical, or nasal corticosteroids in the last 30 days (up to 1% topical hydrocortisone is permitted).
• Participants using a leukotriene receptor antagonist for maintenance treatment of asthma.
• Participant with a history of any illness that, in the opinion of the study investigator, might confound the results of the study or poses an additional risk to the participant by their participation in the study.
• Participant with a history of immunological disease or malignancy within the past 5 years, with the exception of non-melanoma skin cancer.
• Participant with positive drug screen (participants on prescribed medication resulting in a positive drug screen result may still be enrolled at the discretion of the investigator).
• Participant has had major surgery or participated in another investigational study within 4 weeks prior to the Screening Visit.
• Participants taking any herbal supplements during trial conduct.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

5

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo	Drug: Placebo; Placebo tablets, orally, up to five tablets per dose every 4 hours, for 7 days; Drug: Loratadine; 10-mg tablets, orally, once per day at a dose not to exceed 10 mg in a 24-hour period.; Other Names: Claritin®
Experimental: PE 10 mg	Drug: Phenylephrine HCl; 10-mg immediate-release tablets, orally, up to 4 tablets per dose every 4 hours, for 7 days; Other Names: SCH 002063; Drug: Placebo; Placebo tablets, orally, up to five tablets per dose every 4 hours, for 7 days; Drug: Loratadine; 10-mg tablets, orally, once per day at a dose not to exceed 10 mg in a 24-hour period.; Other Names: Claritin®
Experimental: PE 20 mg	Drug: Phenylephrine HCl; 10-mg immediate-release tablets, orally, up to 4 tablets per dose every 4 hours, for 7 days; Other Names: SCH 002063; Drug: Placebo; Placebo tablets, orally, up to five tablets per dose every 4 hours, for 7 days; Drug: Loratadine; 10-mg tablets, orally, once per day at a dose not to exceed 10 mg in a 24-hour period.; Other Names: Claritin®
Experimental: PE 30 mg	Drug: Phenylephrine HCl; 10-mg immediate-release tablets, orally, up to 4 tablets per dose every 4 hours, for 7 days; Other Names: SCH 002063; Drug: Placebo; Placebo tablets, orally, up to five tablets per dose every 4 hours, for 7 days; Drug: Loratadine; 10-mg tablets, orally, once per day at a dose not to exceed 10 mg in a 24-hour period.; Other Names: Claritin®
Experimental: PE 40 mg	Drug: Phenylephrine HCl; 10-mg immediate-release tablets, orally, up to 4 tablets per dose every 4 hours, for 7 days; Other Names: SCH 002063; Drug: Placebo; Placebo tablets, orally, up to five tablets per dose every 4 hours, for 7 days; Drug: Loratadine; 10-mg tablets, orally, once per day at a dose not to exceed 10 mg in a 24-hour period.; Other Names: Claritin®

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean Change From Baseline Over the Entire Treatment Period in the Daily Reflective Nasal Congestion Score	The reflective nasal congestion score was captured in participant diaries just before the 8:00 a.m. dose and 12 hours later just before the 8:00 p.m. dose. Participants rated congestion on a 4-point scale of severity from 0 (best) to 3 (worst), with 0 = absent symptoms, 1 = mild symptoms, 2 = moderate symptoms, and 3 = severe symptoms. The daily reflective nasal congestion symptom score was defined as the average of the morning and evening reflective nasal congestion score for the entire treatment period. Baseline was defined as the average of the daily scores over the 4 consecutive 24-hour periods before randomization.	Baseline, Day 7

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean Change From Baseline in the Morning (a.m.) Symptom Score for the Nasal Reflective Symptom Assessment by Study Day of the Treatment Period	The morning reflective nasal congestion score was captured in participant diaries just before the 8:00 am dose. It is a composite score including four nasal symptoms: rhinorrhea, nasal congestion, nasal itching, and sneezing and it is rated on a 0-3 scale of severity with 0 = absent symptoms, 1 = mild symptoms, 2 = moderate symptoms, and 3 = severe symptoms.	Baseline and Days 2, 3, 4, 5, 6, and 7
Mean Change From Baseline in the Evening (p.m.) Symptom Score for the Nasal Reflective Symptom Assessment by Study Day of the Treatment Period	The evening reflective nasal congestion score was captured in participant diaries just before the 8;00 p.m. dose. It is a composite score including four nasal symptoms: rhinorrhea, nasal congestion, nasal itching, and sneezing and is rated on a 0-3 scale of severity with 0 = absent, 1 = mild symptoms, 2 = moderate symptoms, and 3 = severe symptoms.	Baseline and Days 1, 2, 3, 4, 5, 6, and 7
Mean Change From Baseline in the a.m. Symptom Score for the Instantaneous Nasal Symptom Assessment by Study Day of the Treatment Period	Instantaneous assessment of nasal symptoms was performed once daily before the morning dose. The instantaneous assessment was a composite score of four nasal symptoms: rhinorrhea, nasal congestion, nasal itching, and sneezing and is rated on a 0-3 scale of severity with 0 = absent symptoms, 1 = mild symptoms, 2 = moderate symptoms, and 3 = severe symptoms.	Baseline and Day 2, 3, 4, 5, 6, and 7
Mean Change From Baseline for the Daily Reflective Nasal Symptom Assessment Score by Study Day of the Treatment Period	The reflective nasal congestion score was captured in participant diaries just before the 8:00 a.m. dose and 12 hours later just before the 8:00 p.m. dose. It is a composite score including four nasal symptoms: rhinorrhea, nasal congestion, nasal itching, and sneezing and is rated on a 0-3 scale of severity with 0 = absent symptoms, 1 = mild symptoms, 2 = moderate symptoms, and 3 = severe symptoms. The daily reflective nasal congestion symptom score was defined as the average of the morning and evening reflective nasal congestion score for the entire treatment period.	Baseline and Days 1, 2, 3, 4, 5, 6, and 7
Mean Change From Baseline for the Instantaneous Nasal Symptom Assessment Score By Study Day of the Treatment Period	Instantaneous assessment of nasal symptoms was performed once daily before the morning dose. The instantaneous assessment was a composite score of four nasal symptoms: rhinorrhea, nasal congestion, nasal itching, and sneezing and is rated on a 0-3 scale of severity with 0 = absent symptoms, 1 = mild symptoms, 2 = moderate symptoms, and 3 = severe symptoms.	Baseline and Days 1, 2, 3, 4, 5, 6, and 7
Time to Maximal Effect	Time to maximal effect is defined as the earliest time that the nasal congestion symptom score demonstrates the greatest numerical difference from the placebo in change from baseline. The mean change from baseline scores for a treatment arm and for the placebo arm at each day and timepoint of the treatment period (Day 1 morn, Day 1 eve, etc) were calculated. Then the difference between the placebo and treatment arm means at each day/timepoint of the treatment period was calculated and recorded the day/timepoint that the difference between the treatment arm and the placebo was highest.	Baseline up to Day 7
Change From Baseline for the Instantaneous Nasal Symptom Assessment Score at Day 7	The magnitude of effect was measured as the change from baseline for the instantaneous nasal symptom assessment score at Day 7. Instantaneous assessment of nasal symptoms was performed once daily before the morning dose. The instantaneous assessment was a composite score of four nasal symptoms: rhinorrhea, nasal congestion, nasal itching, and sneezing and is rated on a 0-3 scale of severity with 0 = absent symptoms, 1 = mild symptoms, 2 = moderate symptoms, and 3 = severe symptoms.	Baseline, Day 7

Collaborators and Investigators

• Sponsor: Bayer

Publications and helpful links

General Publications

• Meltzer EO, Ratner PH, McGraw T. Oral Phenylephrine HCl for Nasal Congestion in Seasonal Allergic Rhinitis: A Randomized, Open-label, Placebo-controlled Study. J Allergy Clin Immunol Pract. 2015 Sep-Oct;3(5):702-8. doi: 10.1016/j.jaip.2015.05.007. Epub 2015 Jul 2.

Study record dates

Study Major Dates

• Study Start: March 1, 2011
• Primary Completion (Actual): May 1, 2011
• Study Completion (Actual): June 1, 2011

Study Registration Dates

• First Submitted: April 4, 2011
• First Submitted That Met QC Criteria: April 5, 2011
• First Posted (Estimate): April 6, 2011

Study Record Updates

• Last Update Posted (Estimate): March 11, 2015
• Last Update Submitted That Met QC Criteria: February 20, 2015
• Last Verified: February 1, 2015

More Information

Terms related to this study

• Keywords: Seasonal allergies
• Additional Relevant MeSH Terms: Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Immune System Diseases; Hypersensitivity, Immediate; Otorhinolaryngologic Diseases; Respiratory Hypersensitivity; Hypersensitivity; Nose Diseases; Rhinitis; Rhinitis, Allergic; Rhinitis, Allergic, Seasonal; Physiological Effects of Drugs; Adrenergic Agents; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; Autonomic Agents; Peripheral Nervous System Agents; Protective Agents; Adrenergic alpha-Agonists; Adrenergic Agonists; Cardiotonic Agents; Dermatologic Agents; Respiratory System Agents; Anti-Allergic Agents; Histamine H1 Antagonists; Histamine Antagonists; Histamine Agents; Antipruritics; Sympathomimetics; Histamine H1 Antagonists, Non-Sedating; Vasoconstrictor Agents; Mydriatics; Nasal Decongestants; Adrenergic alpha-1 Receptor Agonists; Loratadine; Phenylephrine; Oxymetazoline
• Other Study ID Numbers: 18123; CL2010-06; P08156 (Other Identifier: Merck)