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Dymista effectively treats nasal congestion, ocular itch in patients with allergic rhinitis

SAN ANTONIO — Azelastine hydrochloride and fluticasone propionate dual agent nasal spray effectively reduced ocular itch and nasal congestion in patients with seasonal allergic rhinitis, according to study results presented at the 2015 American College of Allergy, Asthma and Immunology Annual Scientific Meeting.

The dual-agent nasal spray appeared more effective for the reduction of symptoms than azelastine hydrochloride and fluticasone propionate alone.

“[Azelastine hydrochloride/fluticasone propionate (Dymista, Meda Pharmaceuticals)] is a unique dual-agent spray that more rapidly relieves nasal and eye symptoms than single-agent sprays like fluticasone and azelastine,” William C. Howland, MD, an allergist at Allergy and Asthma Center of Austin, told Healio.com/Allergy. “Additionally Dymista effectively reduced nasal congestion — one of the most troubling nasal symptoms.”

Howland and colleagues conducted a post-hoc analysis to analyze the efficacy of the dual-agent nasal spray in patients with seasonal allergic rhinitis who had nasal congestion or ocular itch as their primary symptom.

The analysis included 610 patients aged 12 years and older. Researchers randomly assigned study participants to one of four regimens — azelastine hydrochloride and fluticasone propionate, azelastine hydrochloride, fluticasone propionate or placebo — during a 2-week double blind trial in the midst of Texas Mountain Cedar season.

Patients received one spray per nostril per day. Total daily doses of fluticasone propionate were 200 μg, and total daily doses of azelastine hydrochloride were 548 μg.

Researchers attempted to identify changes from baseline in the 12-hour reflective total nasal symptom score, as well as changes from baseline in the 12-hour reflective total ocular symptom score.

Patients reported symptom severity twice daily on a four-point scale, with the highest daily score of six for any symptom.

Mean baseline congestion score was ≥5.3 and mean baseline ocular itch score was ≥5.

Patients who reported nasal congestion as their predominant symptom (n = 368) and treated with the dual-agent nasal spray demonstrated greater symptom reduction from baseline (–1.41) than those treated with fluticasone propionate (–0.9) or azelastine hydrochloride (–0.83) alone.

Patients who reported ocular itch as their predominant symptom (n = 334) and who had been treated with the dual-agent nasal spray had greater reductions from baseline (–1.41) than those treated with fluticasone propionate (–0.87) or azelastine hydrochloride (–1.04) alone.

Patients treated with the dual-agent spray achieved nasal relief on the second day, whereas patients treated with either agent alone did not achieve nasal relief before day 9.

The degree of ocular itch relief in patients treated with the dual-agent spray occurred on the second day. That same degree was not reached before day 10 in the fluticasone propionate study arm or day 4 in the azelastine hydrochloride study arm.

The dual-agent spray could help patients reduce their use of additional medications, Howland told Healio.com/Allergy

“Dymista also reduced eye itching associated with allergy and, as a single agent, may reduce the need for decongestant pills and sprays and antihistamine eye drops,” he said. – by Ryan McDonald

Reference: Howland W, et al. Poster 275. Presented at: American College of Allergy, Asthma and Immunology Annual Scientific Meeting; Nov. 5-9; San Antonio.

Disclosure: Howland reports being a clinical investigator for numerous companies, including Meda Pharmaceuticals.