Phase 4
N=140
Nasacort AQ Hypothalamic-Pituitary-Adrenal (HPA) Axis Study in Children With Allergic Rhinitis
Rhinitis, Allergic, Perennial and/or Seasonal
Bottom Line
View on ClinicalTrials.gov: NCT01154153 ↗Enrolled (actual)
140
Serious AEs
0.7%
Results posted
Oct 2011
Primary outcome: Primary: Ratio of Serum Cortisol Area Under Curve [AUC(0-24 hr)] at the End of Treatment to Baseline — 0.938; 0.898 Ratio
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 4
- Interventions
- Placebo nasal spray (Drug); Triamcinolone acetonide aqueous (TAA-AQ) nasal spray (NASACORT AQ) (Drug); Claritin® Syrup (Drug)
- Age
- Pediatric · 2+ yrs
- Sex
- All
- Sponsor
- Sanofi
- Primary completion
- Oct 2010
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Ratio of Serum Cortisol Area Under Curve [AUC(0-24 hr)] at the End of Treatment to Baseline |
0.938; 0.898 | — |
| SECONDARY Change From Baseline in the Reflective Total Nasal Symptom Score (rTNSS) |
-0.22; -1.07 | 0.0007 sig |
| SECONDARY Number of Participants by Relief Level as Evaluated by the Physician |
11; 9; 18; 13; 16; 20 | 0.1332 |
| SECONDARY Number of Participants by Relief Level as Evaluated by the Participant |
9; 5; 17; 22; 16; 13 | 0.3314 |
| SECONDARY Number of Participants Using Rescue Medication |
8; 8; 24; 19 | — |
| SECONDARY The Percent of Days of Rescue Medication Use During the Double-blind Treatment Phase |
4.02; 3.07 | — |
Summary
The primary objective was to evaluate the effect of a 6-week treatment with TAA-AQ (110 μg) and TAA-AQ (220 μg) once daily (QD) versus placebo on hypothalamic-pituitary-adrenal (HPA) axis function as measured by serum cortisol AUC(0-24 hr) in children (>=2 to <12 years old) with allergic rhinitis (AR).
Eligibility Criteria
Participants who met the following criteria were eligible for this study:
Inclusion Criteria
- History of AR documented by the investigator, as follows:
- At least a 1-year clinical history (6-month history if the participant was >= 2 to =7 years of age (or younger according to the governing institutional review board [IRB]) had to provide a signed assent form
Exclusion Criteria
- Concomitant medical condition that might have interfered with the administration of a nasal spray, including anatomical abnormalities of the nose, face (eg, polyposis, markedly deviated septum)
- Presence of any active, untreated, or clinically significant musculoskeletal, endocrinologic, gastrointestinal, hepatic, respiratory, cardiovascular, or neurological condition that might have interfered with the study
- Any conditions or treatment that might have affected the HPA axis or the plasma cortisol assay, including but not limited to:
- Documented disorder involving the hypothalamus, pituitary, or adrenal gland
- Current use of serotonergic, dopaminergic, adrenergic, cholinergic agonists and antagonists, opiates, immunomodulatory, hormonal drugs, and lipid-lowering agents
- Treatment with systemic corticosteroids (oral, intravenous, intramuscular, or intra-articular) within 3 months prior to Visit 1
- Treatment with systemic corticosteroids for > 2 courses received up to 1 year before Visit 1 was exclusionary. Up to 2 courses of systemic corticosteroids, each course not exceeding 14 days, up to 1 year before Visit 1 was allowed
- Treatment with inhaled, intranasal, or high-potency topical corticosteroids within 6 weeks of Visit 1
- History of hospitalization due to asthma within 1 year before screening. Participants with mild asthma that was well-controlled without the use of inhaled corticosteroids within 6 weeks prior to Visit 1 were eligible for the study
- Any clinically significant (as determined by the investigator) abnormal laboratory test at Visit 1
- Morning serum cortisol outside the reference range at Visit 1
- Any of the following missing serum cortisol samples from the Visit-2 collection: first sample (before administration of investigational product), 20-hour sample, 24-hour sample, or any 2 consecutive samples
- Any medical condition where use of corticosteroids might have been contraindicated or could have led to disease exacerbation (eg, glaucoma, cataract, ocular herpes simplex, tuberculosis, growth retardation)
- History of hypersensitivity to corticosteroids or to the rescue medication, investigational product, or to any of their excipients
- Unresolved upper respiratory tract infection, sinus infection, or nasal candidiasis (ie, symptomatic or under treatment) within the last 2 weeks prior to Visit 1 and Visit 3
- Females of childbearing potential not protected by effective contraceptive method of birth control or were unwilling to abstain from sexual activity and/or, were unwilling or unable to test for pregnancy. Only female adolescent with onset of menses were to be checked by serum pregnancy test at Visit 1
- Pregnant female adolescent (who tested positive for pregnancy at Visit 1) The above information was not intended to contain all considerations relevant to potential participation in a clinical trial.
Data sourced from ClinicalTrials.gov (NCT01154153). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.