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14-09-2011 | Immunology | Article

Intranasal capsaicin provides effective relief for non-allergic rhinitis


Free abstract

MedWire News: Patients with non-allergic rhinitis (NAR) may benefit from homeopathic intranasal capsaicin, suggest study findings showing rapid improvement in symptoms with 2 weeks use.

These findings are of importance as only a few medications are approved for treatment of NAR, say the researchers.

Single intermittent short-term dosing studies with intranasal capsaicin in AR and NAR have shown its effectiveness for reducing nasal congestion and discharge, but previous preparations have required co-administration of local anesthetic due to capsaicin's potent irritant effect.

Jonathan Bernstein (University of Cincinnati, Ohio, USA) and co-authors randomly assigned 42 patients with diagnosed NAR with or without an allergic component to receive treatment with ICX72 (Sinus Buster), an intranasal capsaicin and eucalyptol spray, or control spray. Patients and investigators were blinded to the allotted treatment, which was administered twice daily over a 2-week period.

The primary endpoint was change in total nasal symptom scores (TNSS) from baseline to end of the study. Secondary endpoints included changes in individual symptom scores (ISS) over 2 weeks and average time to first relief. Mean TNSS and ISS were recorded after single dosing at different intervals over 60 minutes.

Patients assigned to the active nasal spray showed significantly more improvement in TNSS after the 2-week treatment compared with placebo-treated patients, at 52% versus 30%.

Compared with placebo-treated patients, those receiving the active nasal spray also showed significantly greater improvements for the mean ISS of nasal congestion (53 vs 27%), sinus pressure (62 vs 29%), sinus pain (64 vs 33%), and headache (65 vs 37%). However, no significant difference was seen between groups for sneezing, rhinorrhea, and postnasal drip.

The average time to first relief for ICX72 was significantly faster compared with placebo, at 52.6 versus 184.3 seconds. Furthermore, a significantly larger percentage of ICX72-treated patients experienced first relief in less than 1 minute compared with those receiving placebo, at 80% versus 45%.

Analysis of symptom score questionnaires showed that patients treated with the active spray had significantly more improvement in nasal congestion, sinus pressure, sinus pain, and headache at 5, 10, 15, and 30 minutes compared with placebo. These improvements persisted for nasal congestion, sinus pain, and sinus pressure for up to 60 minutes. In addition, significantly more improvement was seen among patients receiving the active spray for TNSS at 10, 15, 30, and 60 minutes.

The study also showed that fewer ICX72-treated patients required rescue medication compared with the placebo group, at 30% versus 45% for the first week and 20% versus 45% for the second week, respectively.

No significant difference was observed between ICX72 and placebo in reported adverse events, which included increased nasal congestion, headaches, postnasal drainage, rhinorrhea, transient stinging/burning lasting only a few seconds, blood-tinged mucus, and fatigue. In addition, no rebound congestion or impaired olfaction was seen among ICX72-treated patients at the end of the study.

"This is the first controlled clinical trial to demonstrate that an intranasal capsaicin spray, ICX72 (Sinus Buster), provides a rapid onset of relief for [mixed rhinitis] and NAR subjects, while also providing safe, sustained symptom relief over a 2-week treatment period," conclude the authors in the Annals of Allergy, Asthma and Immunology.

By Ingrid Grasmo

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