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Zhai J, Traebert M, Zimmermann K, Delaunois A, Royer L, Salvagiotto G, Carlson C, Lagrutta A. Comparative study for the IMI2-NeuroDeRisk project on microelectrode arrays to derisk drug-induced seizure liability. J Pharmacol Toxicol Methods 2023; 123:107297. [PMID: 37499956 DOI: 10.1016/j.vascn.2023.107297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/01/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION In the framework of the IMI2-NeuroDeRisk consortium, three in vitro electrophysiology assays were compared to improve preclinical prediction of seizure-inducing liabilities. METHODS Two cell models, primary rat cortical neurons and human induced pluripotent stem cell (hiPSC)-derived glutamatergic neurons co-cultured with hiPSC-derived astrocytes were tested on two different microelectrode array (MEA) platforms, Maestro Pro (Axion Biosystems) and Multiwell-MEA-System (Multi Channel Systems), in three separate laboratories. Pentylenetetrazole (PTZ) and/or picrotoxin (PTX) were included in each plate as positive (n = 3-6 wells) and ≤0.2% DMSO was used as negative controls (n = 3-12 wells). In general, concentrations in a range of 0.1-30 μM were tested, anchored, when possible, on clinically relevant exposures (unbound Cmax) were tested. Activity thresholds for drug-induced changes were set at 20%. To evaluate sensitivity, specificity and predictivity of the cell models, seizurogenic responses were defined as changes in 4 or more endpoints. Concentration dependence trends were also considered. RESULTS Neuronal activity of 33 compounds categorized as positive tool drugs, seizure-positive or seizure-negative compounds was evaluated. Acute drug effects (<60 min) were compared to baseline recordings. Time points < 15 min exhibited stronger, less variable responses to many of the test agents. For many compounds a reduction and cessation of neuronal activity was detected at higher test concentrations. There was not a single pattern of seizurogenic activity detected, even among tool compounds, likely due to different mechanisms of actions and/or off-target profiles. A post-hoc analysis focusing on changes indicative of neuronal excitation is presented. CONCLUSION All cell models showed good sensitivity, ranging from 70 to 86%. Specificity ranged from 40 to 70%. Compared to more conventional measurements of evoked activity in hippocampal slices, these plate-based models provide higher throughput and the potential to study subacute responses. Yet, they may be limited by the random, spontaneous nature of their network activity.
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Affiliation(s)
- Jin Zhai
- Merck & Co., Inc., Rahway, NJ, USA
| | | | | | | | | | | | - Coby Carlson
- Fujifilm Cellular Dynamics, Inc., Madison, WI, USA
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Marko M, Pawliczak R. Pharmacotherapy and immunotherapy of allergic rhinitis induced by house dust mite, grass, and birch pollen allergens: a meta-analysis of randomized clinical trials. Expert Rev Respir Med 2023; 17:607-621. [PMID: 37489655 DOI: 10.1080/17476348.2023.2241364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/24/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The aim of this study was to assess the efficacy and safety of oral antihistamines (AHs), intranasal antihistamines (INAH) intranasal glucocorticosteroids (INCS), subcutaneous immunotherapy (SCIT), and sublingual immunotherapy (SLIT) in the management of allergic rhinitis (AR). The authors focused on the division into selected AR's triggers: house dust mites (HDMs), grass pollen, and birch pollen. METHODS For each drug and allergen class, a meta-analysis of the efficacy and adverse events (AEs) was performed. The obtained results were presented as a therapeutic index (TIX-Score). RESULTS Twenty-seven randomized clinical trials (RCTs) were included. The best total efficacy was observed for: HDMs for INCS and grass pollen for combination of INCS with INAH in a single device and for INAH. Considering the data that was obtained for birch pollen, SLIT showed statistically significant total efficacy. Summation scores for efficacy and AEs showed highest TIX-Score for combination of INCS and INAH in a single device in grass pollen. CONCLUSIONS Treatment methods selected for this review may serve as an effective and safe treatment in reducing perennial and seasonal AR's symptoms. However, due to high heterogeneity probably associated with potential confounders existence in control in some cases, results should be interpreted with caution.
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Affiliation(s)
- Monika Marko
- Department of Immunopathology, Faculty of Medicine, Division of Biomedical Science, Medical University of Lodz, Lodz, Poland
| | - Rafał Pawliczak
- Department of Immunopathology, Faculty of Medicine, Division of Biomedical Science, Medical University of Lodz, Lodz, Poland
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The add-on effect of an intranasal antihistamine with an intranasal corticosteroid in Japanese cedar pollinosis. Auris Nasus Larynx 2023; 50:81-86. [PMID: 35768286 DOI: 10.1016/j.anl.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/12/2022] [Accepted: 05/09/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Combination intranasal drugs with a corticosteroid and antihistamine are available in several countries with better effect than treatments with single agents. However, it remains unclear whether this effect is also seen in Japanese cedar pollinosis (JCP), the most prevalent seasonal allergic rhinitis in Japan. We investigated the effect of an add-on intranasal antihistamine with an intranasal corticosteroid in JCP during the pollen dispersal period. (UMIN000025508) METHODS: We performed a double-blinded, randomized, placebo-controlled trial from March 1 to 14, 2017. Patients (n = 20 per group) received either a mometasone furoate nasal spray (MFNS) plus a levocabastine nasal spray (levocabastine group) or MFNS plus a placebo nasal spray (placebo group). The primary endpoint was the difference in the total nasal symptom score (TNSS) after treatment between the two groups. Differences in the total ocular symptom score, total symptom score, total medication score, total symptom-medication score, and five individual symptoms as well as safety were the secondary endpoints. RESULTS The change in the TNSS from baseline was significantly greater in the levocabastine group than in the placebo group. A significant reduction in the TNSS was observed more than 6 days earlier in the levocabastine group than in the placebo group. Such add-on effects were also seen in the secondary endpoints. Both treatments were well-tolerated. CONCLUSION The intranasal antihistamine provided better control of not only nasal symptoms, but also of ocular symptoms, and decreased the need for rescue medications when added to intranasal corticosteroid treatment in JCP patients.
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Lim L, Lipari M, Kale-Pradhan P. Intranasal Olopatadine: Mometasone in the Treatment of Seasonal Allergic Rhinitis. Ann Pharmacother 2022; 57:570-578. [PMID: 36123818 DOI: 10.1177/10600280221124230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To review the pharmacology, efficacy, and safety of intranasal olopatadine hydrochloride-mometasone furoate (OM) combination in the treatment of seasonal allergic rhinitis (SAR). DATA SOURCES The PubMed database and ClinicalTrials.gov were searched using the following terms: mometasone + olopatadine, GSP301, mometasone furoate, and olopatadine hydrochloride. STUDY SELECTION AND DATA EXTRACTION Articles published in English between January 1987 and August 2022 related to pharmacology, safety, and clinical trials were assessed. DATA SYNTHESIS In 2 phase II clinical trials, twice-daily (BID) and once-daily (QDay) intranasal OM demonstrated significant improvements in reflective total nasal symptom score (rTNSS) (BID P < 0.001 and QDay P < 0.001) and instantaneous total nasal symptom score (iTNSS) (BID P < 0.001 and P < 0.0001; QDay P < 0.001 and P < 0.0001). In 2 phase III clinical trials, BID OM showed significant improvements in rTNSS vs. placebo (P < 0.001), olopatadine monotherapy (P = 0.03 and P = 0.003), and mometasone monotherapy (P = 0.02 and P = 0.059). RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE OM is indicated for treatment of SAR symptoms. Caution with use must be considered for certain high-risk patients, existing tuberculosis; fungal, bacterial, viral, or parasitic infections; or ocular herpes simplex. Due to its quick and sustained onset of action, OM may be an ideal agent for initial treatment of moderate-severe SAR for patients 12 years and older. CONCLUSION OM significantly improves SAR symptoms and is a viable treatment option in short-term SAR.
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Affiliation(s)
- Lauren Lim
- Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| | - Melissa Lipari
- Ambulatory Care, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, and Ascension St. John Hospital and Medical Center, Detroit, MI, USA
| | - Pramodini Kale-Pradhan
- Infectious Diseases, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, and Ascension St. John Hospital, Detroit, MI, USA
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Prenner BM, Amar NJ, Hampel FC, Caracta CF, Wu W. Efficacy and safety of GSP301 nasal spray in children aged 6-11 with seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2022; 129:618-626.e2. [DOI: 10.1016/j.anai.2022.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/06/2022] [Accepted: 07/24/2022] [Indexed: 10/16/2022]
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Chen R, Zheng D, Zhang Y, Sima G. Efficacy and safety of twice-daily olopatadine-mometasone combination nasal spray (GSP301) in the treatment of allergic rhinitis: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2021; 279:1691-1699. [PMID: 34591150 DOI: 10.1007/s00405-021-07085-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE GSP301 is a fixed-dose combination of olopatadine hydrochloride (antihistamine) and mometasone furoate (corticosteroid). This meta-analysis aims to evaluate the efficacy and safety of GSP301 in the treatment of allergic rhinitis. METHODS A systematic review and meta-analysis were conducted. The data were collected from PubMed, Cochrane Central Register of Controlled Trials and Embase databases till June 2021. In patients with AR, short-term (2/6 weeks) and long-term (52 weeks) effects of GSP301 were assessed. Average morning and evening 12-h reflective total nasal symptom score (rTNSS), instantaneous total nasal symptom score (iTNSS), reflective total ocular symptom score (rTOSS), instantaneous total ocular symptom score(iTOSS), Physician-assessed nasal symptom score (PNSS), rhinoconjunctivitis quality of life (RQLQ), rhinitis control assessment test (RCAT) and adverse events (AEs) were measured. RESULTS Five randomized controlled trials were included. GSP301 showed greatly improvement in rTNSS (MD = - 0.99; [95% CI - 1.19 to - 0.79]; P < 0.01; I2 = 0), iTNSS (MD = - 1.05; [95% CI - 1.44 to - 0.67]; P < 0.01; I2 > 50%), rTOSS (MD = - 0.50; [95% CI - 0.72 to - 0.29]; P < 0.01; I2 = 0), iTOSS (MD = - 0.64; [95% CI - 1.02 to - 0.26]; P < 0.01; I2 > 50%), PNSS (MD = - 1.01; [95% CI - 1.32 to - 0.69]; P < 0.01; I2 = 22.13%), RQLQ (MD = - 0.43; [95% CI - 0.57 to - 0.30]; P < 0.01; I2 = 0%) and RCAT (MD = 1.94; [95% CI 1.43-2.45]; P < 0.01; I2 = 0%) in the short term. No statistical difference was observed in the outcome of long-term PNSS, RQLQ and RCAT. CONCLUSION GSP301 is a safe and well-tolerated medication. It showed short-term benefits for seasonal and perennial AR, but may not help to improve patients' quality of life and rhinitis control in the long run.
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Affiliation(s)
- Ru Chen
- Bengbu Medical College Graduate Department, Bengbu, China.,Department of Otolaryngology, Affiliated Hospital of Jiaxing University, No. 1882 Zhonghuan South Road, Jiaxing, China
| | - Dandan Zheng
- Bengbu Medical College Graduate Department, Bengbu, China
| | - Yajun Zhang
- Department of Otolaryngology, Affiliated Hospital of Jiaxing University, No. 1882 Zhonghuan South Road, Jiaxing, China
| | - Guoqi Sima
- Bengbu Medical College Graduate Department, Bengbu, China. .,Department of Otolaryngology, Affiliated Hospital of Jiaxing University, No. 1882 Zhonghuan South Road, Jiaxing, China.
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Mountain cedar allergy: A review of current available literature. Ann Allergy Asthma Immunol 2021; 128:645-651. [PMID: 34582944 DOI: 10.1016/j.anai.2021.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To review the literature related to mountain cedar in terms of allergic disease and societal impact. DATA SOURCES English-language articles obtained through PubMed searches with relevance to mountain cedar allergies. STUDY SELECTIONS Articles with the following search terms were included: mountain cedar, Juniperus ashei, juniper, allergy, pollen, cedar fever, Jun a 1, and San Antonio. RESULTS A total of 61 relevant articles were selected regarding mountain cedar and its distribution, phylogenetics, allergens, potency, cross-reactivity, pollen counting and monitoring, symptoms, diagnosis, treatment, and future research. CONCLUSION Mountain cedar remains a major cause of allergic rhinoconjunctivitis in the south central United States during the winter months. Key treatment strategies involve a combination of allergen avoidance, pharmacologic therapy, and subcutaneous immunotherapy. Allergists can help affected patients in their management of "cedar fever."
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Ecevit MC, Özcan M, Haberal Can İ, Çadallı Tatar E, Özer S, Esen E, Atan D, Göde S, Elsürer Ç, Eryılmaz A, Uslu Coşkun B, Yazıcı ZM, Dinç ME, Özdoğan F, Günhan K, Bilal N, Korkut AY, Kasapoğlu F, Türk B, Araz Server E, Önerci Çelebi Ö, Şimşek T, Kum RO, Adalı MK, Eren E, Yüksel Aslıer NG, Bayındır T, Çakır Çetin A, Enise Göker A, Adadan Güvenç I, Köseoğlu S, Soylu Özler G, Şahin E, Şahin Yılmaz A, Güne C, Aksoy Yıldırım G, Öca B, Durmuşoğlu M, Kantekin Y, Özmen S, Orhan Kubat G, Köybaşı Şanal S, Altuntaş EE, Selçuk A, Yazıcı H, Baklacı D, Yaylacı A, Hancı D, Doğan S, Fidan V, Uygur K, Keleş N, Cingi C, Topuz B, Çanakçıoğlu S, Önerci M. Turkish Guideline for Diagnosis and Treatment of Allergic Rhinitis (ART). Turk Arch Otorhinolaryngol 2021; 59:1-157. [PMID: 34212158 PMCID: PMC8221269 DOI: 10.4274/tao.2021.suppl.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECT To prepare a national guideline for Otorhinolaryngologist who treat allergic rhinitis patients. METHODS The study was conducted by three authors, namely the writing support team. The support team made the study plan, determined the writing instructions, chose the subgroups including the advisory committee, the advisors for authors and the authors. A workshop was organized at the very beginning to explain the details of the study to the team. Advisors took the chance to meet their coworkers in their subgroups and determined the main headings and subheadings of the guideline, together with the authors. After key words were determined by the authors, literature search was done in various databases. The authors keep in touch with the advisors and the advisors with the advisory committee and the support group at every stage of the study. National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline. Only Guideline and meta-analyses published in last seven years (2013-2017) and randomized controlled studies published in last two years (2015-2017) were included. After all work was completed by the subgroups, support team brought all work together and edited the article. RESULTS A detailed guideline about all aspects of allergic rhinitis was created. CONCLUSION The authors believe that this guideline will enable a compact and up-to-date information on allergic rhinitis to healthcare professionals. This guideline is the first in the field of Otolaryngology in Turkey. It should be updated at regular intervals.
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Affiliation(s)
- Mustafa Cenk Ecevit
- Department of Otorhinolaryngology, Dokuz Eylül University Faculty of Medicine, İzmir
| | - Müge Özcan
- Department of Otorhinolaryngology, University of Health Sciences Turkey Faculty of Medicine, Ankara
| | - İlknur Haberal Can
- Department of Otorhinolaryngology, Yozgat Bozok University Faculty of Medicine, Yozgat
| | - Emel Çadallı Tatar
- Department of Otorhinolaryngology, University of Health Sciences Turkey Faculty of Medicine, Ankara
| | - Serdar Özer
- Department of Otorhinolaryngology, Hacettepe University Faculty of Medicine, Ankara
| | - Erkan Esen
- Department of Otorhinolaryngology, Derince Training and Research Hospital, İzmit
| | - Doğan Atan
- Department of Otorhinolaryngology, Lokman Hekim Hospital, Ankara
| | - Sercan Göde
- Department of Otorhinolaryngology, Ege University Faculty of Medicine, İzmir
| | - Çağdaş Elsürer
- Department of Otorhinolaryngology, Selçuk University Faculty of Medicine, Konya
| | - Aylin Eryılmaz
- Department of Otorhinolaryngology, Adnan Menderes University Faculty of Medicine, Aydın
| | - Berna Uslu Coşkun
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Zahide Mine Yazıcı
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Faculty of Medicine, İstanbul
| | - Mehmet Emre Dinç
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Fatih Özdoğan
- Department of Otorhinolaryngology, Derince Training and Research Hospital, İzmit
| | - Kıvanç Günhan
- Department of Otorhinolaryngology, Celal Bayar University, Manisa
| | - Nagihan Bilal
- Department of Otorhinolaryngology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş
| | - Arzu Yasemin Korkut
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Fikret Kasapoğlu
- Department of Otorhinolaryngology, Uludağ University Faculty of Medicine, Bursa
| | - Bilge Türk
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Ela Araz Server
- Department of Otorhinolaryngology, University of Health Sciences Turkey, İstanbul Training and Research Hospital, İstanbul
| | - Özlem Önerci Çelebi
- Department of Otorhinolaryngology, University of Health Sciences Turkey, İstanbul Training and Research Hospital, İstanbul
| | - Tuğçe Şimşek
- Department of Otorhinolaryngology, Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital, Amasya
| | - Rauf Oğuzhan Kum
- Department of Otorhinolaryngology, University of Health Sciences Turkey Faculty of Medicine, Ankara
| | - Mustafa Kemal Adalı
- Department of Otorhinolaryngology, Trakya University Faculty of Medicine, Edirne
| | - Erdem Eren
- Department of Otorhinolaryngology, Atatürk Training and Research Hospital, İzmir
| | - Nesibe Gül Yüksel Aslıer
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Bursa Yüksek İhtisas Training and Research Hospital, Bursa
| | - Tuba Bayındır
- Department of Otorhinolaryngology, İnönü University Faculty of Medicine, Malatya
| | - Aslı Çakır Çetin
- Department of Otorhinolaryngology, Dokuz Eylül University Faculty of Medicine, İzmir
| | - Ayşe Enise Göker
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Işıl Adadan Güvenç
- Department of Otorhinolaryngology, Bakırçay University Faculty of Medicine, Çiğli Training and Research Hospital, İzmir
| | - Sabri Köseoğlu
- Department of Otorhinolaryngology, Sıtkı Koçman University Faculty of Medicine, Muğla
| | - Gül Soylu Özler
- Department of Otorhinolaryngology, Mustafa Kemal University Faculty of Medicine, Hatay
| | - Ethem Şahin
- Bayındır Heathcare Group İçerenköy Hospital, İstanbul
| | - Aslı Şahin Yılmaz
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Ümraniye Training and Research Hospital, İstanbul
| | - Ceren Güne
- Department of Otorhinolaryngology, Atatürk Training and Research Hospital, İzmir
| | - Gökçe Aksoy Yıldırım
- University of Health Sciences Turkey, Bozyaka Training and Research Hospital, Department of Otorhinolaryngology, İzmir
| | - Bülent Öca
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Mehmet Durmuşoğlu
- Department of Otorhinolaryngology, Bakırçay University Faculty of Medicine, Çiğli Training and Research Hospital, İzmir
| | - Yunus Kantekin
- Department of Otorhinolaryngology University of Health Sciences Turkey, Kayseri City Hospital, Kayseri
| | - Süay Özmen
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Bursa Yüksek İhtisas Training and Research Hospital, Bursa
| | - Gözde Orhan Kubat
- Department of Otorhinolaryngology, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya
| | - Serap Köybaşı Şanal
- Department of Otorhinolaryngology, Abant İzzet Baysal University Faculty of Medicine, Bolu
| | - Emine Elif Altuntaş
- Department of Otorhinolaryngology, Sivas Cumhuriyet University Faculty of Medicine, Sivas
| | - Adin Selçuk
- Department of Otorhinolaryngology, Bahçeşehir University Faculty of Medicine, İstanbul
| | - Haşmet Yazıcı
- Department of Otorhinolaryngology, Balıkesir University Faculty of Medicine, Balıkesir
| | - Deniz Baklacı
- Department of Otorhinolaryngology, Bülent Ecevit University Faculty of Medicine, Zonguldak
| | - Atılay Yaylacı
- Department of Otorhinolaryngology, Kocaeli University Faculty of Medicine, Kocaeli
| | - Deniz Hancı
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Sedat Doğan
- Department of Otorhinolaryngology, Adıyaman University Faculty of Medicine, Adıyaman
| | - Vural Fidan
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Eskişehir City Hospital, Eskişehir
| | - Kemal Uygur
- Department of Otorhinolaryngology, Gazi University Faculty of Medicine, Ankara
| | - Nesil Keleş
- Department of Otorhinolaryngology, İstanbul University İstanbul Faculty of Medicine, İstanbul
| | - Cemal Cingi
- Department of Otorhinolaryngology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir
| | - Bülent Topuz
- Department of Otorhinolaryngology, Pamukkale University Faculty of Medicine, Denizli
| | - Salih Çanakçıoğlu
- Department of Otorhinolaryngology, İstanbul University İstanbul Faculty of Medicine, İstanbul
| | - Metin Önerci
- Department of Otorhinolaryngology, Hacettepe University Faculty of Medicine, Ankara
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Klimek L, Price D, Gálffy G, Emmeluth M, Koltun A, Kopietz F, Nguyen DT, van Weissenbruch R, Pohl W, Kuhl HC, Scadding G, Mullol J. Effect of Specific Immunoglobulin E Response and Comorbidities on Effectiveness of MP-AzeFlu in a Real-Life Study. Int Arch Allergy Immunol 2020; 181:754-764. [PMID: 32829329 DOI: 10.1159/000508749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/19/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Phenotyping allergic rhinitis (AR) by immunoglobulin E (IgE) sensitivity and comorbidities may help characterize AR and provide a framework for treatment decisions. METHODS This prospective, noninterventional study evaluated the effectiveness of MP-AzeFlu (azelastine hydrochloride plus fluticasone propionate intranasal spray formulation) across AR phenotypes. Patients with moderate-to--severe seasonal or perennial AR for whom MP-AzeFlu was prescribed were enrolled. AR subpopulations (ARPs) were assigned based on the classification of IgE response and comorbidities. AR symptoms over the previous 24 h were documented using an AR visual analog scale (AR-VAS), with ratings from "not at all bothersome" (0 mm) to "extremely bothersome" (100 mm), at the inclusion visit and on days 1, 3, 7, and the last day of the study (approximately day 14). AR quality-of-life measures were recorded using a VAS. RESULTS A total of 1,103 patients with AR were included. Mean baseline AR-VAS scores ranged from 70.3 to 75.1 mm (severe) across ARPs. In the overall population, 86.6% of patients responded to treatment (AR-VAS score <50 mm on ≥1 days). In the ARPs, response rates ranged from 79.3 to 89.6%. Mean reduction in AR-VAS scores ranged from 47.9 to 40.9 mm, a decrease from severe to mild across all ARPs. Quality-of-life VAS scores were similarly reduced in the total population and ARPs. DISCUSSION/CONCLUSION MP-AzeFlu treatment reduced VAS severity and quality-of-life scores from baseline in the total population and ARPs, supporting MP-AzeFlu as an effective treatment for all patients with moderate-to-severe AR, regardless of AR phenotype or comorbidities.
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Affiliation(s)
- Ludger Klimek
- Zentrum für Rhinologie und Allergologie, Wiesbaden, Germany,
| | - David Price
- Primary Care Respiratory Medicine, University of Aberdeen, Aberdeen, United Kingdom
| | | | | | | | | | - Duc Tung Nguyen
- MEDA Pharma GmbH & Co. KG (A Mylan Co.), Bad Homburg, Germany
| | | | - Wolfgang Pohl
- Karl Landsteiner Gesellschaft, Institut für Klinische und Experimentelle Pneumologie, Vienna, Austria
| | | | - Glenis Scadding
- Royal National Throat, Nose and Ear Hospital, London, United Kingdom
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic Barcelona, IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Spain
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Price D, Klimek L, Gálffy G, Emmeluth M, Koltun A, Kopietz F, Nguyen DT, van Weissenbruch R, Pohl W, Kuhl HC, Scadding G, Mullol J. Allergic rhinitis and asthma symptoms in a real-life study of MP-AzeFlu to treat multimorbid allergic rhinitis and asthma. Clin Mol Allergy 2020; 18:15. [PMID: 32782442 PMCID: PMC7412849 DOI: 10.1186/s12948-020-00130-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 07/28/2020] [Indexed: 12/30/2022] Open
Abstract
Background Asthma affects up to nearly 40% of patients with allergic rhinitis (AR). Poor control of AR symptoms is associated with poor asthma control. The goal of this study was to evaluate the effect of AR treatment with MP-AzeFlu on symptoms of AR as well as symptoms of asthma. Methods This prospective study used a visual analog scale (VAS) to assess symptoms of AR and asthma before and after treatment with MP-AzeFlu (Dymista®; azelastine hydrochloride plus fluticasone propionate; 1 spray in each nostril twice daily for 2 weeks). Participants suffered from moderate-to-severe AR according to Allergic Rhinitis and its Impact on Asthma criteria, with acute AR symptoms (AR-VAS scores ≥ 50 mm) on inclusion day. In addition to symptom assessment, patients recorded the impact of AR symptoms on quality-of-life measures before, during, and at the conclusion of the treatment period (approximately 14 days). Patients self-reported change in frequency of their usage of asthma reliever medication on the last day of treatment. Results Of 1103 study participants, 267 (24.2%) had comorbid asthma. These participants reported using a mean of 5.1 puffs of asthma reliever medication in the week before treatment with MP-AzeFlu. A total of 81.8% of patients with comorbid asthma responded to AR therapy (AR-VAS < 50 mm on at least 1 study day). Among patients with AR and comorbid asthma, MP-AzeFlu was associated with improved VAS scores across all study parameters, including AR symptom severity, asthma symptom severity, sleep quality, daily work or school activities, daily social activities, and daily outdoor activities. Asthma symptom severity decreased from a mean of 48.9 mm to 24.1 mm on the VAS. Self-reported frequency of asthma reliever medication use was reduced for 57.6% of participants (n = 139/241). Conclusion MP-AzeFlu used to relieve AR symptoms was associated with reduced asthma symptom VAS scores and frequency of asthma reliever medication usage. Changes in overall symptoms of AR and asthma were correlated.
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Affiliation(s)
- David Price
- Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD UK.,Optimum Patient Care, Cambridge, UK.,Observational and Pragmatic Research Institute (OPRI), Pte
- #02-05 883 North Bridge Road, Singapore, 198785 Singapore
| | - Ludger Klimek
- Zentrum für Rhinologie und Allergologie, Wiesbaden, Germany
| | | | - Melanie Emmeluth
- MEDA Pharma GmbH & Co. KG (A Mylan Company), Bad Homburg, Germany
| | | | | | - Duc Tung Nguyen
- MEDA Pharma GmbH & Co. KG (A Mylan Company), Bad Homburg, Germany
| | | | - Wolfgang Pohl
- Karl Landsteiner Gesellschaft, Institut für Klinische und experimentelle Pneumologie, Vienna, Austria
| | | | | | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic Barcelona, IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Catalonia Spain
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11
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Andrews CP, Mohar D, Salhi Y, Tantry SK. Efficacy and safety of twice-daily and once-daily olopatadine-mometasone combination nasal spray for seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2019; 124:171-178.e2. [PMID: 31734334 DOI: 10.1016/j.anai.2019.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/01/2019] [Accepted: 11/06/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND GSP301 is an investigational fixed-dose combination nasal spray of olopatadine hydrochloride (antihistamine) and mometasone furoate (corticosteroid). OBJECTIVE To evaluate efficacy and safety of GSP301 in patients with seasonal AR (SAR). METHODS In this phase 2, double-blind, parallel-group study, patients (≥12 years of age) with SAR were equally randomized to twice-daily GSP301 (olopatadine 665 μg and mometasone 25 μg), once-daily GSP301 (olopatadine 665 μg and mometasone 50 μg), twice-daily or once-daily olopatadine monotherapy (665 μg), mometasone monotherapy (twice-daily 25 μg or once-daily 50 μg), or placebo for 14 days. The primary endpoint-mean change from baseline in morning and evening reflective Total Nasal Symptom Score (rTNSS)-was analyzed using analysis of covariance (ANCOVA; P < .05 = statistically significant). Average morning and evening 12-hour instantaneous TNSS (iTNSS), ocular symptoms, individual symptoms, onset of action, quality of life, and adverse events (AEs) were also assessed. RESULTS A total of 1111 patients were randomized. Twice-daily GSP301 provided statistically significant and clinically meaningful rTNSS improvements vs placebo (P < .001), twice-daily olopatadine (P = .049), and mometasone (P = .004). Similar significant improvements in iTNSS were observed with twice-daily GSP301 vs placebo (P < .001) and twice-daily mometasone (P = .007); improvements were not significant vs olopatadine (P = .058). Once-daily GSP301 provided significant rTNSS and iTNSS improvements vs placebo and once-daily olopatadine (P < .01, all) but improvements were not significant vs mometasone. Treatment-emergent AEs rates were 10.8%, 9.5%, and 8.2%, with twice-daily GSP301, once-daily GSP301, and placebo, respectively. CONCLUSION Twice-daily GSP301 treatment was efficacious and well tolerated, providing statistically significant and clinically meaningful improvements in rTNSS (primary endpoint) vs placebo and both monotherapies. TRIAL REGISTRATION Clinicaltrials.gov Identifier NCT02318303.
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Affiliation(s)
| | - Dale Mohar
- Kerrville Research Associates, Kerrville, Texas
| | - Yacine Salhi
- Glenmark Pharmaceuticals Inc, Paramus, New Jersey
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12
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Getgood A, Dhollander A, Malone A, Price J, Helliwell J. Pharmacokinetic Profile of Intra-articular Fluticasone Propionate Microparticles in Beagle Dog Knees. Cartilage 2019; 10:139-147. [PMID: 28786292 PMCID: PMC6425547 DOI: 10.1177/1947603517723687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The objective of this pilot study was to determine time point(s) at which maximum concentration of fluticasone propionate (Cmax) occurs in synovial fluid and plasma in Beagle dog knees after intra-articular injection of EP-104IAR. DESIGN EP-104IAR is composed of fluticasone propionate drug crystals coated with heat-treated polyvinyl alcohol (PVA) to result in extended release properties. Thirty-two Beagle dogs had an injection of EP-104IAR into the knee joint at 2 different dose levels (0.6 mg and 12 mg). Outcome measures included plasma, synovial fluid, and articular cartilage fluticasone propionate concentrations as well as histological analysis of cartilage and synovium at a variety of time points up to 58 days postdosing. RESULTS Intra-articular administration of 0.6 and 12 mg EP-104IAR was well tolerated. Early minor abnormalities found on microscopy resolved by the end of the study. There were no quantifiable concentrations of fluticasone propionate in plasma of animals administered 0.6 mg at any of the sampling time points. Highest concentrations in plasma following 12 mg administration occurred 1 day postdose and declined with a half-life of approximately 45 days. Highest concentrations of fluticasone propionate in synovial fluid and cartilage generally occurred 5 days postdose in both dose groups and declined with a half-life of approximately 11 to 14 days. CONCLUSIONS EP-104IAR is capable of providing a safe and prolonged local exposure to a corticosteroid in the synovial joint while minimizing systemic exposure, with peak exposures occurring within a matter of days after dosing before declining in all tissues in a predictable manner.
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Affiliation(s)
- Alan Getgood
- The University of Western Ontario, London, Ontario, Canada
| | - Aad Dhollander
- The University of Western Ontario, London, Ontario, Canada,Department of Orthopaedic Surgery and Traumatology, AZ KLINA, Brasschaat, Belgium,Aad Dhollander, The Fowler Kennedy Sport Medicine Clinic, The University of Western Ontario, 3M Centre, London, Ontario, N6A 3K7, Canada.
| | - Amanda Malone
- Eupraxia Pharmaceuticals, Victoria, British Columbia, Canada
| | - James Price
- Eupraxia Pharmaceuticals, Victoria, British Columbia, Canada
| | - James Helliwell
- Eupraxia Pharmaceuticals, Victoria, British Columbia, Canada
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13
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Gross GN, Berman G, Amar NJ, Caracta CF, Tantry SK. Efficacy and safety of olopatadine-mometasone combination nasal spray for the treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2019; 122:630-638.e3. [PMID: 30910440 DOI: 10.1016/j.anai.2019.03.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/08/2019] [Accepted: 03/15/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND GSP301 nasal spray is a fixed-dose combination of olopatadine hydrochloride (antihistamine) and mometasone furoate (corticosteroid). OBJECTIVE To evaluate the efficacy and safety of GSP301 in patients with seasonal allergic rhinitis (SAR). METHODS In this double-blind study, eligible patients (≥12 years of age) with SAR were randomized 1:1:1:1 to twice-daily GSP301 (665 μg of olopatadine and 25 μg of mometasone), olopatadine (665 μg), mometasone (25 μg), or placebo for 14 days. The primary end point-mean change from baseline in average morning and evening 12-hour reflective Total Nasal Symptom Score (rTNSS)-was analyzed via a mixed-effect model repeated measures (P < .05 was considered to be statistically significant). Additional assessments included average morning and evening 12-hour instantaneous TNSS (iTNSS), ocular symptoms, individual symptoms, onset of action, quality of life, and adverse events (AEs). RESULTS A total of 1176 patients were randomized. GSP301 provided statistically significant and clinically meaningful rTNSS improvements vs placebo (least squares mean difference, -1.09; 95% CI, -1.49 to -0.69; P < .001) and vs olopatadine (P = .03) and mometasone (P = .02). Similar significant improvements in iTNSS were also observed with GSP301 (P < .05 for all). Furthermore, GSP301 significantly improved overall ocular symptoms, individual nasal and ocular symptoms, and quality of life vs placebo (P ≤ .001 for all). Onset of action for GSP301 was observed within 15 minutes and was maintained at all subsequent timepoints. Treatment-emergent AEs occurred in 15.6%, 12.6%, 9.6%, and 9.5% of patients in the GSP301, olopatadine, mometasone, and placebo groups, respectively. CONCLUSION GSP301 is efficacious and well tolerated vs placebo for treating SAR-associated nasal and ocular symptoms, with a rapid onset of action of 15 minutes in adult and adolescent patients 12 years and older. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov: NCT02870205.
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Affiliation(s)
- Gary N Gross
- Pharmaceutical Research & Consulting Inc, Dallas, Texas.
| | - Gary Berman
- Clinical Research Institute Inc, Minneapolis, Minnesota
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14
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Roca-Ferrer J, Pujols L, Pérez-González M, Alobid I, Callejas B, Vicens-Artés S, Fuentes M, Valero A, Picado C, Castor D, Nguyen D, Mullol J. Superior effect of MP-AzeFlu than azelastine or fluticasone propionate alone on reducing inflammatory markers. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2018; 14:86. [PMID: 30574167 PMCID: PMC6299636 DOI: 10.1186/s13223-018-0311-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 12/12/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND MP-AzeFlu, intranasal formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP), is superior to AZE or FP alone for treatment of allergic rhinitis (AR). However, the precise anti-inflammatory mechanism of action of MP-AzeFlu has not been characterized. OBJECTIVE To investigate the anti-inflammatory effects of MP-AzeFlu compared with AZE or FP alone in an established in vitro model of eosinophilic inflammation. METHODS Nasal mucosal epithelial cells and peripheral blood eosinophils were obtained from human volunteers. Epithelial cells were stimulated with 10% fetal bovine serum (FBS) in the presence of MP-AzeFlu, AZE, or FP (1:102 to 1:105 dilution). Concentrations of interleukin (IL)-6, IL-8, and granulocyte-macrophage colony-stimulating factor (GM-CSF) were measured by ELISA. Eosinophils were incubated in 10% human epithelial cell-conditioned medium (HECM) and survival assessed by trypan blue dye exclusion. Results are expressed as mean ± SEM percentage secretion/survival compared with FBS/HECM (respectively). RESULTS FP and MP-AzeFlu (all dilutions) and AZE (1:102) significantly reduced IL-6 secretion and eosinophil survival compared with positive controls. At 1:102 dilution, IL-6 secretion was significantly lower with MP-AzeFlu (38.3 ± 4.2%, compared with FBS = 100%) than with AZE (76.1 ± 4.9%) or FP (53.0 ± 4.9%). At 1:102 dilution, eosinophil survival was significantly lower with MP-AzeFlu at day 3 (17.5 ± 3.0%) and day 4 (2.4 ± 1.4%, compared with HECM = 100%) than with AZE (day 3: 75.2 ± 7.2%; day 4: 44.0 ± 9.7%) or FP (day 3: 38.5 ± 3.5%; day 4: 14.6 ± 4.0%). CONCLUSION Greater reductions in cytokine secretion and eosinophil survival observed with MP-AzeFlu in vitro may underlie MP-AzeFlu's superior clinical efficacy vs. AZE or FP alone observed in AR patients.
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Affiliation(s)
- Jordi Roca-Ferrer
- Clinical and Experimental Respiratory Immunoallergy, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Laura Pujols
- Clinical and Experimental Respiratory Immunoallergy, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Maria Pérez-González
- Clinical and Experimental Respiratory Immunoallergy, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Isam Alobid
- Clinical and Experimental Respiratory Immunoallergy, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036 Barcelona, Catalonia Spain
| | - Borja Callejas
- Clinical and Experimental Respiratory Immunoallergy, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Sònia Vicens-Artés
- Clinical and Experimental Respiratory Immunoallergy, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Mireya Fuentes
- Clinical and Experimental Respiratory Immunoallergy, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Antonio Valero
- Clinical and Experimental Respiratory Immunoallergy, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Allergy Section, Respiratory and Allergy Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - César Picado
- Clinical and Experimental Respiratory Immunoallergy, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Allergy Section, Respiratory and Allergy Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Dennis Castor
- Clinical Science & Operations, Meda Pharma GmbH & Co. KG (A Mylan Company), Bad Homburg, Germany
| | - DucTung Nguyen
- Clinical Science & Operations, Meda Pharma GmbH & Co. KG (A Mylan Company), Bad Homburg, Germany
| | - Joaquim Mullol
- Clinical and Experimental Respiratory Immunoallergy, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036 Barcelona, Catalonia Spain
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15
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Patel P, Salapatek AM, Tantry SK. Effect of olopatadine-mometasone combination nasal spray on seasonal allergic rhinitis symptoms in an environmental exposure chamber study. Ann Allergy Asthma Immunol 2018; 122:160-166.e1. [PMID: 30321655 DOI: 10.1016/j.anai.2018.10.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/01/2018] [Accepted: 10/09/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND GSP301 nasal spray is a fixed-dose combination of the antihistamine olopatadine hydrochloride and the corticosteroid mometasone furoate intended for seasonal allergic rhinitis (SAR) treatment. OBJECTIVE To evaluate the efficacy and safety of once-daily or twice-daily GSP301 in a ragweed pollen environmental exposure chamber. METHODS In this randomized, double-blind, double-dummy study, adults (18-65 years old) with SAR were equally randomized to 665 μg of olopatadine and 25 μg of mometasone (twice-daily GSP301), 665 μg of olopatadine and 50 μg of mometasone (once-daily GSP301), a US Food and Drug Administration-approved formulation of 137 μg of azelastine and 50 μg of fluticasone twice-daily (AzeFlu), a US Food and Drug Administration-approved formulation of 665 μg of olopatadine twice-daily, or placebo (twice-daily). During 2 visits (baseline and end of 14-day treatment), participants assessed SAR symptoms at specified time points. The primary end point-mean change from baseline in instantaneous total nasal symptom score (iTNSS) for twice-daily or once-daily GSP301 vs placebo-was analyzed by analysis of covariance. Onset of action, ocular symptoms, and adverse events were assessed. RESULTS A total of 180 participants were randomized. Treatment with twice-daily or once-daily GSP301 provided statistically significant improvements in iTNSS vs placebo (twice-daily GSP301: least squares mean difference, -3.60; 95% confidence interval [CI], -4.89 to -2.30; once-daily GSP301: least squares mean difference, -3.05; 95% CI, -4.35 to -1.76; P < .0001 for both). Significant improvements in iTNSS with twice-daily GSP301 occurred by 10 minutes after dosing (-1.26; 95% CI, -2.30 to -0.21; P = .02) and were maintained at all later time points except one (2.5 hours). Treatment-emergent adverse events occurred in 22.2%, 30.6%, 25.0%, 22.2%, and 16.7% of participants in the twice-daily GSP301, once-daily GSP301, AzeFlu, olopatadine, and placebo groups, respectively. CONCLUSION In an environmental exposure chamber model, twice-daily and once-daily GSP301 treatments were well tolerated and provided statistically significant and clinically meaningful SAR symptom improvement vs placebo. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03444506.
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Affiliation(s)
- Piyush Patel
- Inflamax Research Inc, Mississauga, Ontario, Canada.
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16
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Morse E, Fujiwara RJT, Mehra S. The Association of Industry Payments to Physicians with Prescription of Brand-Name Intranasal Corticosteroids. Otolaryngol Head Neck Surg 2018; 159:442-448. [PMID: 29865931 DOI: 10.1177/0194599818774739] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives To examine the association of industry payments for brand-name intranasal corticosteroids with prescribing patterns. Study Design Cross-sectional retrospective analysis. Setting Nationwide. Subjects and Methods We identified physicians prescribing intranasal corticosteroids to Medicare beneficiaries 2014-2015 and physicians receiving payment for the brand-name intranasal corticosteroids Dymista and Nasonex. Prescription and payment data were linked by physician, and we compared the proportion of prescriptions written for brand-name intranasal corticosteroids in industry-compensated vs non-industry-compensated physicians. We associated the number and dollar amount of industry payments with the relative frequency of brand-name prescriptions. Results In total, 164,587 physicians prescribing intranasal corticosteroids were identified, including 7937 (5%) otolaryngologists; 10,800 and 3886 physicians received industry compensation for Dymista and Nasonex, respectively. Physicians receiving industry payment for Dymista prescribed more Dymista as a proportion of total intranasal corticosteroid prescriptions than noncompensated physicians (3.1% [SD = 9.6%] vs 0.2% [SD = 2.5%], respectively, P < .001). Similar trends were seen for Nasonex (12.0% [SD = 16.8%] vs 4.8% [SD = 13.6%], P < .001). The number and dollar amount of payment were significantly correlated to the relative frequency of Dymista (ρ = 0.26, P < .001 and ρ = 0.20, P < .001, respectively) and Nasonex prescriptions (ρ = 0.09, P < .001 and ρ = 0.15, P < .001, respectively). For Dymista, this association was stronger in otolaryngologists than general practitioners ( P < .001). There was a stronger correlation between the percentage of prescriptions and the number and dollar amount of payments for Dymista than for Nasonex ( P = .014 and P < .001). Conclusions Industry compensation for brand-name intranasal corticosteroids is significantly associated with prescribing patterns. The magnitude of association may depend on physician specialty and the drug's time on the market.
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Affiliation(s)
- Elliot Morse
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Rance J T Fujiwara
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Saral Mehra
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA.,2 Yale Cancer Center, New Haven, Connecticut, USA
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Popov TA, Åberg N, Emberlin J, Josling P, Ilyina NI, Nikitin NP, Church M. Methyl-cellulose powder for prevention and management of nasal symptoms. Expert Rev Respir Med 2017; 11:885-892. [PMID: 28862062 DOI: 10.1080/17476348.2017.1375408] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION HPMC-p, an inert micronized powder form of hydroxy-propyl-methyl-cellulose, when insufflated nasally, provides a natural barrier against pollen allergens and noxious agents. This overview assesses the efficacy and safety of this patented powder product and delivery system without an analogue among the cellulose derivatives. Areas covered: Twenty-six studies with HPMC-p were critically appraised to obtain an updated characteristic of the product. Most studies assessed the efficacy of HPMC-p as a nasal barrier enforcing measure: one experimental setup evaluated its ability to prevent or delay the diffusion of allergen through it, two clinical studies used allergen provocation tests, and the remaining relied on clinical criteria in open real world or placebo controlled designs. Two studies checked if HPMC-p could enhance the efficacy of drugs applied nasally to treat local symptoms. The studies, using either nasal allergen challenge or natural exposure of patients to environmental allergen, support the hypothesis that HPMC-p possesses barrier enforcing properties. Also, acute and clinical experiments indicated that intra-nasal application of HPMC-p following local relief medications enhances their ability to suppress symptoms and reduces their long-term use. Expert commentary: Nasal insufflation of HPMC-p provides a mucosal barrier, reducing the nasal symptoms and enhancing the effects of local relief medications.
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Affiliation(s)
- Todor A Popov
- a Clinic of Allergy and Asthma , Medical University Sofia , Sofia , Bulgaria
| | - Nils Åberg
- b Department of Paediatrics , University of Gothenburg , Gothenburg , Sweden
| | | | | | - Natalia I Ilyina
- e State Science Centre , Russian Federal Medical Biological Agency , Moscow , Russia
| | | | - Martin Church
- g Allergie-Centrum-Charité , Universitätsmedizin Berlin , Berlin , Germany
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