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Nasal ObstructionPhase 2NORTOCNCT06830109

Nasal Obstruction With Oxymetazoline and Corticosteroids

A Phase 2 study testing Oxymetazoline Nasal Spray and Budesonide nasal spray in people with Nasal Obstruction, run by Washington University School of Medicine at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This study aims to examine the efficacy and safety of commination oxymetazoline/intranasal steroids for long-term management of chronic nasal obstruction that is recalcitrant to the current standard of care. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Nasal Obstruction
What is being tested?
Oxymetazoline Nasal Spray and Budesonide nasal spray
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteUnited States
Study dates
15 Oct 2024to 30 Dec 2026
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • males and females ages 18 years or older
  • have a history of nasal obstruction
  • have failed a trial of topical steroids (that included at least 1 month of daily use)
  • ability to read, write, and understand English
  • either do not desire surgery or are poor surgical candidates due to medical comorbidities.
  • Patients who have had prior use of oxymetazoline or other nasal decongestants are eligible for the study but must have stopped usage 4 weeks prior to randomization.
  • Must be willing to stop using any other nasal sprays, besides saline, and oral decongestants.

Who cannot join

  • Any history of sinonasal mass/tumor
  • Any history of nasal polyps
  • a known history of chronic sinusitis
  • an allergy to oxymetazoline
  • or who have any medical contraindication to oxymetazoline use, such as pulmonary hypertension.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Nyssa Farrell, MD contact

314-362-7509

nyssa.farrell@wustl.edu

Sara Kukuljan contact

314-362-7563

kukuljas@wustl.edu

United States1 site, 1 recruiting
  • Washington University

    St Louis, Missouri, 63110

    Sara Kukuljan, 314-362-7563, kukuljas@wustl.edu

    Lucas Cruz, BA, 314-362-0549, lucascruz@wustl.edu

    Recruiting

Other trials in United States

About this study

Official title: Nasal Obstruction Randomized Trial With Oxymetazoline and Corticosteroids

This study aims to examine the efficacy and safety of commination oxymetazoline/intranasal steroids for long-term management of chronic nasal obstruction that is recalcitrant to the current standard of care. The investigators hypothesize that combination treatment with oxymetazoline and intranasal corticosteroid spray will provide a larger reduction in nasal obstruction than intranasal corticosteroid alone for patients suffering from chronic nasal obstruction, and there will not be occurrences of rhinitis medicamentosa.

Read the detailed description

Participants will be directed to apply the intranasal spray, at a dosage of two sprays in each nostril, twice daily. The total treatment time for participants in both trial arms is 7 weeks. Participants will be randomized to either 1) oxymetazoline + budesonide intranasal spray or 2) budesonide intranasal spray. Participants will be mailed the intranasal spray directly from the pharmacy. Participants will complete questionnaires via REDCap survey link at baseline, Week 2, Week 4, Week 5, Week 6, and Week 7. A group of 10 participants will be asked to have nasal mucosal biopsies done at baseline and between weeks 4 and 6.

Being tested
Oxymetazoline Nasal Spray, Budesonide nasal spray
Keywords
Oxymetazoline, Corticosteroids, Chronic rhinitis
Medical subject headings
Nasal Obstruction

What participants receive

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

  • Oxymetazoline Nasal SprayDrug

    Also called Afrin (commercial name for oxymetazoline hydrochloride)

    Intra-nasal alpha-adrenergic agonist and vasoconstrictor that is available over-the-counter (OTC)

  • Budesonide nasal sprayDrug

    Also called Rhinocort (commercial name for budesonide)

    Intranasal corticosteroid that is available over-the-counter (OTC)

Study groups in NCT06830109
Study groupRoleWhat they receive
budesonide + oxymetazoline,Experimentalalpha-adrenergic agonist and vasoconstrictor that is available over-the-counter (OTC).
Receives: Drug: Oxymetazoline Nasal Spray; Drug: Budesonide nasal spray
budesonideActive comparatorintranasal corticosteroid that is available OTC.
Receives: Drug: Budesonide nasal spray

What is being measured

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

  1. Rate of Responders

    The primary outcome measure will be the rate of responders (as a percentage) to the intervention defined as the number of participants reporting 2 (Moderately Improved), or 3 (Much Improved) in the Clinical Global Impression of Improvement (CGI-I) assessed after 4 weeks of treatment divided by the total number of participants in each study group.

    CGI-I asks subjects to rate their overall response to treatment using a 7-point Likert scale ranging from -3 to 3 ("Much Worse" to "Much Improved"). Participants responding 2 (Moderately Improved), or 3 (Much Improved) to the the CGI-I question "Compared to the start of the study, how would you rate your nasal breathing now", will be defined as responders to treatment.

    Measured: 4 weeks

Secondary outcomes (3)
  1. Sino-Nasal Outcome Test (SNOT-22)

    SNOT-22 is a 22-question survey designed to measure the physical, functional, and emotional consequences of rhinosinusitis. It contains questions regarding symptoms commonly associated with sinonasal disease.

    Subjects rate each question by using a 0-5 point scale with 0=no problem, 1=very mild problem, 2=mild or slight problem, 3=moderate problem, 4=severe problem, 5=problem as bad as it can be. The SNOT-22 total score ranges from a minimum score of 0 to a maximum score of 110, with higher scores representing worse outcome.

    Measured: baseline, 2 weeks, and 4 weeks

  2. Nasal Obstruction Symptom Evaluation (NOSE)

    NOSE is a disease-specific survey designed to measure nasal obstruction. It consists of 5 questions, each rated on a scale of 0 to 4. The total score represents the sum of the raw scores multiplied by 5 and ranges from 0 to 100, with higher values indicating worse symptoms. A score of 30 is considered indicative of clinically significant nasal airway obstruction.

    Measured: baseline, 2 weeks, 4 weeks

  3. Clinical Global Impression of Severity (CGI-S)

    The CGI-Severity Scale from 1 to 7 (1 is "Not Obstructed at All", 7 is "Completely Obstructed") provides the severity of nasal obstruction as perceived from the patient. Comparison of CGI-S scores at 4 weeks with baseline will help identify subjects that have experienced rebound congestion. The investigators will report the number of patients who report a worsening of their symptoms, as measured by a 1-point (1 category) increase in CGI-S scale at 4 weeks as compared to CGI-S scale at baseline.

    Measured: baseline, week 4

Timeline

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

  1. First posted17 Feb 2025
  2. Study start15 Oct 2024
  3. Primary completion30 Dec 2026 (estimated)
  4. Study completion30 Dec 2026 (estimated)

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Single-center, double-blinded, randomized, controlled trial conducted at Washington University School of Medicine
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06830109
Sponsor's protocol ID
202406175
Acronym
NORTOC
Status last verified
Sep 2025
First submitted
11 Feb 2025
Last updated
11 Sep 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Scarupa MD, Kaliner MA. Nonallergic rhinitis, with a focus on vasomotor rhinitis: clinical importance, differential diagnosis, and effective treatment recommendations. World Allergy Organ J. 2009 Mar;2(3):20-5. doi: 10.1097/WOX.0b013e3181990aac.

    PubMed 23282951
  • Stewart M, Ferguson B, Fromer L. Epidemiology and burden of nasal congestion. Int J Gen Med. 2010 Apr 8;3:37-45. doi: 10.2147/ijgm.s8077.

    PubMed 20463822
  • Thongngarm T, Assanasen P, Pradubpongsa P, Tantilipikorn P. The effectiveness of oxymetazoline plus intranasal steroid in the treatment of chronic rhinitis: A randomised controlled trial. Asian Pac J Allergy Immunol. 2016 Mar;34(1):30-7. doi: 10.12932/AP0649.34.1.2016.

    PubMed 26994623
  • Calvo-Henriquez C, Viera-Artiles J, Rodriguez-Iglesias M, Rodriguez-Rivas P, Maniaci A, Yanez MM, Martinez-Capoccioni G, Alobid I. The Role of Corticosteroid Nasal Irrigations in the Management of Chronic Rhinosinusitis: A State-of-the-Art Systematic Review. J Clin Med. 2023 May 22;12(10):3605. doi: 10.3390/jcm12103605.

    PubMed 37240711
  • Vaidyanathan S, Williamson P, Clearie K, Khan F, Lipworth B. Fluticasone reverses oxymetazoline-induced tachyphylaxis of response and rebound congestion. Am J Respir Crit Care Med. 2010 Jul 1;182(1):19-24. doi: 10.1164/rccm.200911-1701OC. Epub 2010 Mar 4.

    PubMed 20203244
  • Graf P, Juto JE. Decongestion effect and rebound swelling of the nasal mucosa during 4-week use of oxymetazoline. ORL J Otorhinolaryngol Relat Spec. 1994 May-Jun;56(3):157-60. doi: 10.1159/000276633.

    PubMed 7515487
  • Morris S, Eccles R, Martez SJ, Riker DK, Witek TJ. An evaluation of nasal response following different treatment regimes of oxymetazoline with reference to rebound congestion. Am J Rhinol. 1997 Mar-Apr;11(2):109-15. doi: 10.2500/105065897782537197.

    PubMed 9129752
  • Kumar RS, Jain MK, Kushwaha JS, Patil S, Patil V, Ghatak S, Sanmukhani J, Mittal R. Efficacy and Safety of Fluticasone Furoate and Oxymetazoline Nasal Spray: A Novel First Fixed Dose Combination for the Management of Allergic Rhinitis with Nasal Congestion. J Asthma Allergy. 2022 Jun 10;15:783-792. doi: 10.2147/JAA.S357288. eCollection 2022.

    PubMed 35712651
  • Matreja PS, Gupta V, Kaur J, Singh S. Efficacy of fluticasone and oxymetazoline as the treatment for allergic rhinitis. J Clin Diagn Res. 2012;6(1):85-88.

  • Meltzer EO, Bernstein DI, Prenner BM, Berger WE, Shekar T, Teper AA. Mometasone furoate nasal spray plus oxymetazoline nasal spray: short-term efficacy and safety in seasonal allergic rhinitis. Am J Rhinol Allergy. 2013 Mar-Apr;27(2):102-8. doi: 10.2500/ajra.2013.27.3864.

    PubMed 23562197
  • Juvekar MR, Vaidya GK, Majumder A, Pendharkar AD, Irudhayarajan A, Kundu A, Ramesh D, Kumar JD, Jagannatha B, Mathew J, Nikam MP, Mehta M, Chawla N, Hajare P, Gowda PGC, Murthy PVLN, Mathew SM, Damle MV, Kant C, Nair AB, Jaiswal A, Mehta RT. A Real-World Observational Study to Evaluate the Safety and Effectiveness of Fluticasone Furoate-Oxymetazoline Fixed Dose Combination Nasal Spray in Patients with Allergic Rhinitis. Clin Drug Investig. 2024 Feb;44(2):123-130. doi: 10.1007/s40261-023-01338-8. Epub 2024 Jan 9.

    PubMed 38195833
  • Elwany SS, Stephanos WM. Rhinitis medicamentosa. An experimental histopathological and histochemical study. ORL J Otorhinolaryngol Relat Spec. 1983;45(4):187-94. doi: 10.1159/000275642.

    PubMed 6192384
  • Elwany S, Abdel-Salaam S. Treatment of rhinitis medicamentosa with fluticasone propionate--an experimental study. Eur Arch Otorhinolaryngol. 2001 Mar;258(3):116-9. doi: 10.1007/s004050000309.

    PubMed 11374251
  • Knipping S, Holzhausen HJ, Goetze G, Riederer A, Bloching MB. Rhinitis medicamentosa: electron microscopic changes of human nasal mucosa. Otolaryngol Head Neck Surg. 2007 Jan;136(1):57-61. doi: 10.1016/j.otohns.2006.08.025.

    PubMed 17210334
  • Lin CY, Cheng PH, Fang SY. Mucosal changes in rhinitis medicamentosa. Ann Otol Rhinol Laryngol. 2004 Feb;113(2):147-51. doi: 10.1177/000348940411300213.

    PubMed 14994772

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Oxymetazoline Nasal Spray and Budesonide nasal spray in people with Nasal Obstruction, run by Washington University School of Medicine at 1 site in United States.

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 7 inclusion and 5 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: looking for participants now, as of the sponsor's last update on 11 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Nyssa Farrell, MD (314-362-7509, nyssa.farrell@wustl.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rate of Responders (time frame: 4 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06830109, which also lists 29 linked publications.

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 11 Sep 2025.

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