Department of Clinical Immunology and Allergology of I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
National Research Centre, Institute of Immunology Federal Medical-Biological Agency of Russia, Moscow, Russian Federation.
Int Arch Allergy Immunol. 2022;183(2):168-175. doi: 10.1159/000518754. Epub 2021 Sep 14.
Allergic rhinitis (AR) is a disease which affects >24% of the population in Russia. Triamcinolone acetonide (TAA) is a corticosteroid used for treating AR. This post hoc analysis assesses the efficacy of intranasal TAA in improving perennial AR (PAR) symptom scores over 4 weeks.
NASANIF (NCT03317015) was a double-blind, parallel-group, multicenter, prospective, non-inferiority, phase III clinical trial in which patients with PAR were randomized (1:1) to receive TAA or fluticasone propionate (FP) over 4 weeks. Our post hoc analysis evaluates weekly change in PAR symptoms using the reflective Total Nasal Symptom Score (rTNSS), overall and for individual symptoms (sneezing, nasal itching, rhinorrhoea, and nasal obstruction). Proportion of patients and time to achieve a ≥50 or ≥75% reduction in rTNSS were assessed. For rTNSS endpoints, a linear mixed-model methodology was used; for time-to-event endpoints, cumulative incidence functions were estimated using the Kaplan-Meier method, in the per-protocol population.
Of 260 patients, 128 each completed the study and were randomized to receive TAA or FP. From baseline to week 4, the changes in total rTNSS were -7.78 (95% CI: -8.1701 to -7.3967; p < 0.001) and -7.52 (-7.9053 to -7.1320; p < 0.001) for TAA and FP, respectively. Individual symptoms improved significantly from baseline. The proportion of patients achieving ≥50 and ≥75% reductions in total rTNSS was 88.0 and 67.2%, respectively in the TAA group. No significant differences were observed between the TAA and FP in any analyses.
TAA produced effective and prolonged improvement of PAR symptoms over a 4-week treatment period.
变应性鼻炎(AR)是一种影响俄罗斯超过 24%人群的疾病。曲安奈德(TAA)是一种用于治疗 AR 的皮质类固醇。这项事后分析评估了鼻腔内 TAA 在改善常年性 AR(PAR)症状评分方面的 4 周疗效。
NASANIF(NCT03317015)是一项双盲、平行组、多中心、前瞻性、非劣效性 III 期临床试验,其中 PAR 患者以 1:1 的比例随机分配(1:1)接受 TAA 或丙酸氟替卡松(FP)治疗 4 周。我们的事后分析使用反射性总鼻症状评分(rTNSS)评估每周 PAR 症状的变化,包括整体和个别症状(打喷嚏、鼻痒、流涕和鼻塞)。评估达到 rTNSS 改善≥50%或≥75%的患者比例和达到该改善的时间。对于 rTNSS 终点,采用线性混合模型方法;对于时间-事件终点,使用 Kaplan-Meier 方法在符合方案人群中估计累积发生率函数。
在 260 名患者中,128 名患者完成了研究并随机接受 TAA 或 FP 治疗。从基线到第 4 周,rTNSS 总评分的变化分别为 -7.78(95%CI:-8.1701 至-7.3967;p<0.001)和 -7.52(-7.9053 至-7.1320;p<0.001),TAA 和 FP 组分别为-7.78 和-7.52。从基线开始,各单项症状均显著改善。TAA 组分别有 88.0%和 67.2%的患者达到 rTNSS 总评分≥50%和≥75%的改善。在任何分析中,TAA 和 FP 之间均未观察到显著差异。
TAA 在 4 周治疗期间对 PAR 症状产生了有效且持久的改善。