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Oxymetazoline Bridge Therapy With Intranasal Corticosteroids in Pediatric Allergic Rhinitis

12. mai 2026 oppdatert av: Necmi Can Yüksel, MD, Dr. Behcet Uz Children's Hospital

Short-Term Nasal Decongestant as Bridge Therapy Combined With Intranasal Corticosteroids in Children With Persistent Allergic Rhinitis: A Randomized Controlled Trial

Persistent allergic rhinitis in children is commonly treated with intranasal corticosteroids (INS), which are considered first-line therapy. However, the delayed onset of action of INS may reduce patient adherence and delay symptom relief. This randomized controlled study evaluates whether adding short-term oxymetazoline nasal spray during the first 5 days of INS treatment ("bridge therapy") improves clinical outcomes, nasal airflow, quality of life, nasal inflammation, and medication adherence in children with persistent allergic rhinitis.

Children aged 4-18 years with moderate-to-severe persistent allergic rhinitis were randomized into two parallel groups. One group received mometasone furoate nasal spray alone for 4 weeks, while the other group received mometasone furoate combined with oxymetazoline during the first 5 days of treatment. Clinical symptoms, Peak Nasal Inspiratory Flow (PNIF), Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), Nasal Nitric Oxide (nNO), and Medication Adherence Rating Scale (MARS) scores were evaluated.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Allergic rhinitis is one of the most common chronic inflammatory diseases in childhood and significantly affects sleep quality, school performance, daily functioning, and quality of life. Intranasal corticosteroids (INS) are recommended as first-line therapy because of their strong anti-inflammatory effects. However, the onset of symptom relief may take several days or weeks, especially in patients with severe nasal congestion. This delayed onset may negatively affect treatment adherence and early treatment satisfaction.

Short-term use of topical nasal decongestants may provide rapid nasal patency and facilitate delivery of intranasal corticosteroids into the nasal cavity. This study investigates whether short-term oxymetazoline therapy added to the initiation of INS treatment can function as a "bridge therapy" in children with persistent allergic rhinitis.

This prospective randomized controlled study enrolled children aged 4-18 years diagnosed with moderate-to-severe persistent allergic rhinitis according to ARIA guidelines. Participants were randomized into two parallel treatment groups:

  1. Intranasal corticosteroid monotherapy group (mometasone furoate for 4 weeks)
  2. Combination therapy group (mometasone furoate for 4 weeks plus oxymetazoline during the first 5 days)

Clinical symptom severity was assessed using Total Nasal Symptom Score (TNSS). Objective nasal airflow was evaluated with Peak Nasal Inspiratory Flow (PNIF). Nasal inflammation was assessed using Nasal Nitric Oxide (nNO). Disease-specific quality of life was measured using the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), and treatment adherence was evaluated using the Medication Adherence Rating Scale (MARS).

The primary objective of the study is to determine whether bridge therapy improves symptom control compared with intranasal corticosteroid monotherapy. Secondary objectives include evaluating effects on nasal airflow, quality of life, nasal inflammation, and medication adherence.

Studietype

Intervensjonell

Registrering (Faktiske)

76

Fase

  • Fase 4

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Tyrkia (Türkiye)
      • Izmir, Tyrkia (Türkiye), 35180
        • Dr. Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn
  • Voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Children aged 4 to 18 years
  • Diagnosis of moderate-to-severe persistent allergic rhinitis according to ARIA guidelines
  • Ability to comply with study procedures
  • Written informed consent obtained from parents or legal guardians

Exclusion Criteria:

  • Mechanical nasal obstruction (nasal polyposis, severe septal deviation, or adenoid hypertrophy)
  • Acute upper respiratory tract infection within the previous 2 weeks
  • Active smoking or significant passive smoke exposure
  • Current use of allergic rhinitis medications
  • Use of intranasal corticosteroids within the previous 3 months
  • Inability to comply with study procedures

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Intranasal Corticosteroid Monotherapy
Participants received mometasone furoate intranasal spray (100 mcg once daily) for 4 weeks.
Legemiddel: Mometasone Furoate (MF) Metered Dose Inhaler (MDI), 100 mcg
Mometasone furoate intranasal spray administered once daily for 4 weeks.
Eksperimentell: Bridge Therapy (INS + Oxymetazoline)
Participants received mometasone furoate intranasal spray for 4 weeks combined with oxymetazoline nasal spray during the first 5 days of treatment.
Legemiddel: Mometasone Furoate (MF) Metered Dose Inhaler (MDI), 100 mcg
Mometasone furoate intranasal spray administered once daily for 4 weeks.
Legemiddel: Oxymetazoline 0.05% nasal solution
Oxymetazoline nasal spray administered twice daily for 5 days in addition to intranasal corticosteroid therapy.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Total Nasal Symptom Score (TNSS)
Tidsramme: Baseline and Week 4
Evaluation of the change in Total Nasal Symptom Score (TNSS) from baseline to Week 4 between treatment groups.
Baseline and Week 4

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Peak Nasal Inspiratory Flow (PNIF)
Tidsramme: Baseline and Week 4
Change in objective nasal airflow measured by PNIF from baseline to Week 4.
Baseline and Week 4

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ)
Tidsramme: Baseline and Week 4
Evaluation of change in disease-specific quality of life scores.
Baseline and Week 4
Change in Nasal Nitric Oxide Levels (nNO)
Tidsramme: Baseline and Week 4
Evaluation of change in nasal nitric oxide levels as a biomarker of nasal inflammation.
Baseline and Week 4
Medication Adherence Rating Scale (MARS)
Tidsramme: Week 4
Assessment of medication adherence using the Medication Adherence Rating Scale.
Week 4

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Dr. Behcet Uz Children's Hospital

Publikasjoner og nyttige lenker

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Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

2. januar 2025

Primær fullføring (Faktiske)

15. januar 2026

Studiet fullført (Faktiske)

16. januar 2026

Datoer for studieregistrering

Først innsendt

12. mai 2026

Først innsendt som oppfylte QC-kriteriene

12. mai 2026

Først lagt ut (Faktiske)

18. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

18. mai 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

12. mai 2026

Sist bekreftet

1. mai 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • GOA-135

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

Individual participant data (IPD) will not be publicly shared due to institutional policies and protection of participant confidentiality.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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