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RhinosinusitisPhase 3NCT04123405

Efficacy and Safety of Acetylcysteine for the Treatment of Acute Uncomplicated Rhinosinusitis

A Phase 3 study testing acetylcysteine in people with Rhinosinusitis, run by Sandoz at 37 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The trial was conducted as a prospective, randomized, multinational, multicenter, double-blind study in 4 parallel groups of patients. Read more about this study

Who is it for?
Ages 14 to 75 years
Conditions the study is for
Rhinosinusitis
What is being tested?
acetylcysteine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
944 participants
Where
37 sitesin 4 countries
Study dates
22 Oct 2020to 20 Apr 2021
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 14 to 75 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Male or female subjects aged between 14 and 75 years inclusive on the date of consent
  • Diagnosis of acute, uncomplicated rhinosinusitis defined at screening visit 1 and at Visit 2 as:
  • major symptom score (MSS) assessed by the patient ≥8 and ≤12 points for the following: rhinorrhea/ anterior discharge, postnasal drip, nasal congestion, headache, and facial pain/pressure, whereupon the nasal congestion is mandatory and no more than 3 of the 5 symptoms are rated as severe
  • individual score for facial pain/pressure ≥1 (mild) and ≤2 (moderate)
  • presence of symptoms ≤3 days prior to screening visit
  • For adults (≥18 years): Informed consent to participate in the trial provided in written form; For adolescents (≥14 - <18 years): own subject informed consent/ assent to participate in the trial and the informed consent from all parent(s)/ legal guardian(s) provided in written form.

Who cannot join

  • History of hypersensitivity or intolerance to the active substance or any of the excipients of the trial medication
  • Patient with history of hereditary fructose intolerance, galactose intolerance, lactase deficiency or glucose-galactose malabsorption
  • Chronic rhinosinusitis (symptoms lasting longer than 3 months)
  • Subjects who have undergone sinus or nasal surgery for chronic rhinosinusitis in the 6 months prior to screening visit
  • Sinus lavage within 7 days prior to screening visit
  • Odontogenic rhinosinusitis
Show all 33Show fewer
  • Allergic (perennial or seasonal) rhinitis
  • Bronchial asthma or chronic obstructive pulmonary disease
  • Nasal polyposis or clinically relevant nasal septum deviation
  • Concomitant otitis
  • Intranasal or systemic use of corticosteroids within 30 days prior to screening visit
  • Intranasal or systemic use of antibiotics within 30 days prior to screening visit
  • Use of nasal decongestants within 2 days prior to screening visit
  • Concomitant treatment of common cold-like symptoms within 7 days prior to screening visit with any of the following:
  • Analgesics
  • Non-steroidal anti-inflammatory drugs
  • Antihistamines
  • Concomitant use of intranasal saline irrigation
  • Use of immunosuppressive agents within 30 days prior to screening visit
  • Immunocompromised state
  • Suspicion for acute bacterial rhinosinusitis (defined as presence of purulence for 3 to 4 days with fever ≥ 38.3°C)
  • Pregnant or breast-feeding female patient
  • Female patient of childbearing potential (not surgically sterilized/hysterectomized or postmenopausal for at least 1 year) who is not currently using (documented at screening visit) and not willing to use medically reliable methods of contraception for the entire trial duration such as oral, injectable or implantable contraceptives, intrauterine contraceptive devices (IUD), sexual abstinence or vasectomized partner
  • Any other condition of the patient (e.g. serious or unstable medical or psychological condition, acute psychosis) that in the opinion of the investigator may compromise evaluation of the trial treatment or may jeopardize patient's safety, compliance or adherence to protocol requirements
  • Participation in ANY research study involving another investigational medicinal product (IMP) within 30 days prior to screening visit, or simultaneous participation in another clinical study or previous participation in present study
  • Suspected alcohol/ drug dependence or abuse (including heavy smoking: ≥ 20 cigarettes daily)
  • Use of snuff tobacco
  • Legal incapacity and/or other circumstances rendering the patient unable to understand the nature, scope and possible consequences of the trial
  • Subjects who are known or suspected:
  • not to comply with the trial directives
  • not to be reliable or trustworthy
  • to be a dependent person, e.g. a relative, family member, or member/employee of the investigator's or sponsor's staff
  • subject is in custody or submitted to an institution due to a judicial order.

Trial locations and contacts

37 sites in 4 countries.

37 sites in 4 countries

Russia18 sites
  • Sandoz Investigative Site

    Kazan', 420029

  • Sandoz Investigative Site

    Kemerovo, 650066

  • Sandoz Investigative Site

    Moscow, 117552

  • Sandoz Investigative Site

    Moscow, 119571

  • Sandoz Investigative Site

    Moscow, 123184

  • Sandoz Investigative Site

    Moscow, 142190

  • Sandoz Investigative Site

    Novosibirsk, 630051

  • Sandoz Investigative Site

    Ryazan, 390026

  • Sandoz Investigative Site

    Saint Petersburg, 191025

  • Sandoz Investigative Site

    Saint Petersburg, 191186

  • Sandoz Investigative Site

    Saint Petersburg, 192283

  • Sandoz Investigative Site

    Saint Petersburg, 194291

  • Sandoz Investigative Site

    Saint Petersburg, 195197

  • Sandoz Investigative Site

    Saint Petersburg, 196084

  • Sandoz Investigative Site

    Saint Petersburg, 196158

  • Sandoz Investigative Site

    Saint Petersburg, 197376

  • Sandoz Investigative Site

    Smolensk, 214031

  • Sandoz Investigative Site

    Yaroslavl, 150000

Other trials in Russia

Bulgaria9 sites
  • Sandoz Investigative Site

    Burgas, 8000

  • Sandoz Investigative Site

    Gabrovo, 5300

  • Sandoz Investigative Site

    Plovdiv, 4000

  • Sandoz Investigative Site

    Sliven, 8800

  • Sandoz Investigative Site

    Sofia, 1000

  • Sandoz Investigative Site

    Sofia, 1408

  • Sandoz Investigative Site

    Sofia, 1527

  • Sandoz Investigative Site

    Sofia, 1606

  • Sandoz Investigative Site

    Yambol, 8600

Other trials in Bulgaria

Moldova7 sites
  • Sandoz Investigative Site

    Chisinau, 2012

  • Sandoz Investigative Site

    Chisinau, 2025

  • Sandoz Investigative Site

    Chisinau, 2032

  • Sandoz Investigative Site

    Chisinau, 2044

  • Sandoz Investigative Site

    Chisinau, 2051

  • Sandoz Investigative Site

    Chisinau, 37

  • Sandoz Investigative Site

    Orhei, 3005

Other trials in Moldova

Germany3 sites
  • Sandoz Investigative Site

    Aachen, 52074

  • Sandoz Investigative Site

    Dresden, 01139

  • Sandoz Investigative Site

    Duisburg, 47051

Other trials in Germany

About this study

Official title: Efficacy and Safety of Acetylcysteine for the Treatment of Acute Uncomplicated Rhinosinusitis: a Prospective, Randomized, Double-blind, Placebo-controlled Trial

The trial was conducted as a prospective, randomized, multinational, multicenter, double-blind study in 4 parallel groups of patients.

Read the detailed description

The study was the prospective, randomized, multinational, multicenter, double-blind study in 4 parallel groups of patients.

Patients underwent screening examinations at Visit 1. Patients who met all inclusion/ no exclusion criteria were randomized at the baseline visit (Day 1) to the double-blind treatment for a duration of 14 days but in case of delayed final visit (Day 15) the patient could voluntarily take reserve study medication for a maximum of 3 additional days.

After the end of the double-blind treatment phase, the patients underwent an end-of-treatment (EOT) examinations on Day 15 (+3).

A follow-up phone call within 7 days after Day 15 (or earlier in case of premature termination) was performed.

Conditions
Rhinosinusitis
Being tested
acetylcysteine, Placebo
Keywords
acute uncomplicated rhinosinusitis, acetylcysteine
Medical subject headings
Rhinosinusitis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • acetylcysteineDrug

    600 mg tablet

  • PlaceboDrug

    Placebo to acetylcysteine

Study groups in NCT04123405
Study groupRoleWhat they receive
Group A: 600 mg acetylcysteineExperimentalone tablet test product plus three tablets placebo per day (taken as two tablets dissolved in a glass of water, twice daily)
Receives: Drug: acetylcysteine; Drug: Placebo
Group B: 1200 mg acetylcysteineExperimentaltwo tablets test product plus two tablets placebo per day (taken as two tablets dissolved in a glass of water, twice daily)
Receives: Drug: acetylcysteine; Drug: Placebo
Group C: 2400 mg acetylcysteineExperimentalfour tablets test product per day (taken as two tablets dissolved in a glass of water, twice daily)
Receives: Drug: acetylcysteine
Group D: PlaceboPlacebo comparatorfour tablets placebo per day (taken as two tablets dissolved in a glass of water, twice daily)
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean Change From Baseline in the Daily Major Symptom Score (MSS) Over the Entire Treatment Period, Full Analysis Set

    The MSS combines the 5 most relevant symptoms of rhinosinusitis based on expert clinician recommendations (rhinorrhea/ anterior discharge, postnasal drip, nasal congestion, headache, and facial pain/pressure). The patient rated the severity of each of the five symptoms of the MSS using a four-point rating scale of increasing severity (0 = none/not present, 1 = mild, 2 = moderate, 3 = severe). The MSS is then the sum of single ratings with a possible range from 0 to 15.

    Mean change from baseline in the daily Major Symptom Score (MSS) over the entire treatment period was calculated as the average total score from Day 2 to 15 compared to Baseline (Day 1). Negative change from baseline means improvement.

    Measured: Baseline (Day 1), Day 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15

  2. Mean Change From Baseline in the Daily Major Symptom Score (MSS) Over the Entire Treatment Period, Per-Protocol Set

    The MSS combines the 5 most relevant symptoms of rhinosinusitis based on expert clinician recommendations (rhinorrhea/ anterior discharge, postnasal drip, nasal congestion, headache, and facial pain/pressure). The patient rated the severity of each of the five symptoms of the MSS using a four-point rating scale of increasing severity (0 = none/not present, 1 = mild, 2 = moderate, 3 = severe). The MSS is then the sum of single ratings with a possible range from 0 to 15.

    Mean change from baseline in the daily Major Symptom Score (MSS) over the entire treatment period was calculated as the average total score from Day 2 to 15 compared to Baseline (Day 1). Negative change from baseline means improvement.

    Measured: Baseline (Day 1), Day 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15

Secondary outcomes (10)
  1. Time to Onset of Action, Full Analysis Set

    Time to onset of action was defined as first day of active treatment on which MSS showed statistically significant (p value<0.05) improvement from placebo.

    Measured: Baseline (Day 1), Day 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15

  2. Time to Onset of Action, Per-Protocol Set

    Time to onset of action was defined as first day of active treatment on which MSS showed statistically significant (p value<0.05) improvement from placebo.

    Measured: Baseline (Day 1), Day 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15

  3. Major Symptom Score (MSS) Development Over the Course of the Study, Full Analysis Set

    The MSS combines the 5 most relevant symptoms of rhinosinusitis based on expert clinician recommendations (rhinorrhea/ anterior discharge, postnasal drip, nasal congestion, headache, and facial pain/pressure). The patient rated the severity of each of the five symptoms of the MSS using a four-point rating scale of increasing severity (0 = none/not present, 1 = mild, 2 = moderate, 3 = severe). The MSS is then the sum of single ratings with a possible range from 0 to 15.

    Mean change from baseline in the daily Major Symptom Score (MSS) over the entire treatment period was calculated as the average total score from Day 2 to 15 compared to Baseline (Day 1). Negative change from baseline means improvement.

    Measured: Baseline (Day 1), Day 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15

  4. Major Symptom Score (MSS) Development Over the Course of the Study, Per-protocol Set

    The MSS combines the 5 most relevant symptoms of rhinosinusitis based on expert clinician recommendations (rhinorrhea/ anterior discharge, postnasal drip, nasal congestion, headache, and facial pain/pressure). The patient rated the severity of each of the five symptoms of the MSS using a four-point rating scale of increasing severity (0 = none/not present, 1 = mild, 2 = moderate, 3 = severe). The MSS is then the sum of single ratings with a possible range from 0 to 15.

    Mean change from baseline in the daily Major Symptom Score (MSS) over the entire treatment period was calculated as the average total score from Day 2 to 15 compared to Baseline (Day 1). Negative change from baseline means improvement.

    Measured: Baseline (Day 1), Day 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15

  5. Sino-Nasal Outcome Test (SNOT-22) by Visit, Full Analysis Set

    SNOT-22 Questionnaire is a disease specific Health-Related Quality of Life (HRQoL) measure that comprises a list of 22 symptoms and social or emotional consequences of the nasal disorder. Every participant is asked to rate how severe each problem had been on a scale from 0 (no problem) to 5 (problem as bad as it can be). The total score is the sum of the scores for all 22 items, ranging from 0 to 110, with a lower score indicating better HRQoL.

    Measured: Baseline (Day 1), Day 7 and Day 14

  6. Sino-Nasal Outcome Test (SNOT-22) by Visit, Per Protocol Set

    SNOT-22 Questionnaire is a disease specific Health-Related Quality of Life (HRQoL) measure that comprises a list of 22 symptoms and social or emotional consequences of the nasal disorder. Every participant is asked to rate how severe each problem had been on a scale from 0 (no problem) to 5 (problem as bad as it can be). The total score is the sum of the scores for all 22 items, ranging from 0 to 110, with a lower score indicating better HRQoL.

    Measured: Baseline (Day 1), Day 7 and Day 14

  7. Sino-Nasal Outcome Test (SNOT-22) by Change to Baseline, Full Analysis Set

    SNOT-22 Questionnaire is a disease specific Health-Related Quality of Life (HRQoL) measure that comprises a list of 22 symptoms and social or emotional consequences of the nasal disorder. Every participant is asked to rate how severe each problem had been on a scale from 0 (no problem) to 5 (problem as bad as it can be). The total score is the sum of the scores for all 22 items, ranging from 0 to 110, with a lower score indicating better HRQoL. A negative change from baseline in SNOT-22 is considered a favorable outcome.

    Measured: Baseline (Day 1), Day 7 and Day 14

  8. Sino-Nasal Outcome Test (SNOT-22) by Change to Baseline, Per Protocol Set

    SNOT-22 Questionnaire is a disease specific Health-Related Quality of Life (HRQoL) measure that comprises a list of 22 symptoms and social or emotional consequences of the nasal disorder. Every participant is asked to rate how severe each problem had been on a scale from 0 (no problem) to 5 (problem as bad as it can be). The total score is the sum of the scores for all 22 items, ranging from 0 to 110, with a lower score indicating better HRQoL. A negative change from baseline in SNOT-22 is considered a favorable outcome.

    Measured: Baseline (Day 1), Day 7 and Day 14

  9. Number of Responders and Non-responders to Treatment, Full Analysis Set

    Number of responders and non-responders to treatment based on the assessment of overall response to treatment by the investigator were reported.

    Measured: Day 4, 7, 10 and 15

  10. Number of Responders and Non-responders to Treatment, Per-Protocol Set

    Number of responders and non-responders to treatment based on the assessment of overall response to treatment by the investigator were reported.

    Measured: Day 4, 7, 10 and 15

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Oct 2019
  2. Study start22 Oct 2020
  3. Primary completion20 Apr 2021
  4. Study completion20 Apr 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
944 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04123405
Sponsor's protocol ID
2018-08-EFT-1
Other IDs
2019-000060-20, 2019
Status last verified
Oct 2021
First submitted
9 Oct 2019
Last updated
19 Nov 2021
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing acetylcysteine in people with Rhinosinusitis, run by Sandoz at 37 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 33 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Nov 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 37 sites in Russia, Bulgaria, Moldova, Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Nov 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean Change From Baseline in the Daily Major Symptom Score (MSS) Over the Entire Treatment Period, Full Analysis Set (time frame: Baseline (Day 1), Day 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Nov 2021.

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