To assess the efficacy of the herbal medicinal product Sinupret extract versus placebo in the treatment of chronic rhinosinusitis (CRS) in adults.
The aim of the present double-blind, placebo-controlled, parallel-group, randomized, phase III clinical trial is to assess the efficacy, safety, and tolerability of Sinupret extract (3 x 160 mg = 480 mg daily) taken for up to 16-weeks compared with placebo in the treatment of chronic rhinosinusitis (CRS) in adults. In addition, in an exploratory approach to identify potential pharmacological modes of action underlying the expected treatment benefit, the anti-inflammatory activity of Sinupret extract will be assessed in a subset of CRS patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
572
1 coated tablet 3 times a day for 16-weeks (1-1-1)
1 coated tablet 3 times a day for 16-weeks (1-1-1)
MSS-INV at V7
Major Symptom Score (MSS) assessed by the investigator at Visit 7 with Baseline as Covariate; The MSS considers: rhinorrhea \[anterior\], rhinorrhea \[posterior\], nasal congestion, headache, and facial pain/pressure
Time frame: 16 weeks
MSS-INV at V4-6
Major Symptom Score (MSS) assessed by the investigator at Visits 4, 5, and 6 with Baseline as Covariate
Time frame: 12 weeks
MSS-PAT at V4-7
Major Symptom Score (MSS) assessed by the Patient at Visits 4, 5, 6, and 7 with Baseline as Covariate
Time frame: 16 weeks
Minimal MSS-INV at V4-7
Minimal Major Symptom Score (MSS) assessed by the Investigator of all visits from Visits 4, 5, 6, and 7
Time frame: 16 weeks
Minimal MSS-PAT at V4-7
Minimal Major Symptom Score (MSS) assessed by the Patient of all visits from Visits 4, 5, 6, and 7
Time frame: 16 weeks
Investigator's Ratings of CRS symptom
Investigator's ratings of each individual CRS symptom (i.e. rhinorrhea \[anterior\], rhinorrhea \[posterior\], nasal congestion, headache, and facial pain/pressure) at V4, V5, V6, and V7
Time frame: 16 weeks
Patient's Ratings of CRS symptom
Patient's ratings of each individual CRS symptom (i.e. rhinorrhea \[anterior\], rhinorrhea \[posterior\], nasal congestion, headache, and facial pain/pressure) at V4, V5, V6, and V7
Time frame: 16 weeks
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Bionorica Investigative Site
Berlin, Germany
Bionorica Investigative Site
Braunschweig, Germany
Bionorica Investigative Site
Chemnitz, Germany
Bionorica Investigative Site
Dresden, Germany
Bionorica Investigative Site
Dresden, Germany
Bionorica Investigative Site
Dresden, Germany
Bionorica Investigative Site
Dresden, Germany
Bionorica Investigative Site
Duisburg, Germany
Bionorica Investigative Site
Essen, Germany
Bionorica Investigative Site
Frankfurt am Main, Germany
...and 35 more locations
SNOT-22
22-Item Sino-Nasal Outcome Test (SNOT-22)Total Score as well as SNOT-22 primary nasal score (SNOT-22 PNS) and SNOT-22 general quality of life score (SNOT-22 ALQ) at V4, V5, V6, and V7
Time frame: 16 weeks
VAS
Total symptom severity assessed by the patient on a visual analogue scale (VAS) at V4, V5, V6, and V7
Time frame: 16 weeks
Responder Rate
Proportion of patients whose MSS-INV and MSS-PAT improved by ≥30%, ≥40%, ≥50%, ≥60% and ≥70% at V4, V5, V6, and V7. Responders are defined as patients who show at least an MSS improvement of ≥30%
Time frame: 16 weeks
Concomitant drug and non-drug therapy
Patients with permitted concomitant drug and non-drug therapy (i.e. isotonic saline solution as nasal spray, nasal irrigation \[nasal lavage\], or ultrasonic nebulizer) for CRS
Time frame: 22 weeks
Premature Terminations
Number of patients with premature termination due to exacerbation of CRS symptoms
Time frame: 20 weeks
Investigator's and patient's overall assessment of efficacy (questionnaire)
At each on-site visit during the treatment phase (V4 to V7), both the investigator and the patient have to provide an overall assessment of treatment efficacy using 5 categories ("very good", "good", "moderate", "poor", and "very poor"; ranges from 0 to 4).
Time frame: 16 weeks
WPAI:GH questionnaire
Pharmacoeconomic evaluation (utilization of health care resources) based on "Work Productivity and Activity Impairment, Global Health" (WPAI:GH) questionnaire completed by the patient at V4, V5, V6, and V7
Time frame: 22 weeks
Inflammatory Parameter IL-1beta (nasal secretions: substudy)
Absolute concentrations and total amount per sample of interleukin-1β (IL-1beta) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter IL-2 (nasal secretions: substudy)
Absolute concentrations and total amount per sample of interleukin-2 (IL-2) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter IL-4 (nasal secretions: substudy)
Absolute concentrations and total amount per sample of interleukin-4 (IL-4) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter IL-6 (nasal secretions: substudy)
Absolute concentrations and total amount per sample of interleukin-6 (IL-6) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter IL-8 (nasal secretions: substudy)
Absolute concentrations and total amount per sample of interleukin-8 (IL-8) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter IFN-gamma (nasal secretions: substudy)
Absolute concentrations and total amount per sample of interferon gamma (IFN-gamma) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter TNF-alpha (nasal secretions: substudy)
Absolute concentrations and total amount per sample of tumor necrosis factor alpha (TNF-alpha) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter MPO (nasal secretions: substudy)
Absolute concentrations and total amount per sample of myeloperoxidase (MPO) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter ECP (nasal secretions: substudy)
Absolute concentrations and total amount per sample of eosinophil cationic protein (ECP) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter alpha-2-macroglobulin (nasal secretions: substudy)
Absolute concentrations and total amount per sample of α2-macroglobulin (alpha-2-macroglobulin) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter HMGB-1 (nasal secretions: substudy)
Absolute concentrations and total amount per sample of high-mobility group box protein 1 (HMGB-1) in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks
Inflammatory Parameter albumin (nasal secretions: substudy)
Absolute concentrations and total amount per sample of albumin in nasal secretions collected at V2, V5, and V7 for a subset of approximately 60 patients in selected investigational sites in Germany
Time frame: 16 weeks