PMID- 33816038
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210406
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 13
IP  - 3
DP  - 2021 Mar 31
TI  - A Randomized Controlled Pilot Trial to Test the Efficacy of Intranasal 
      Chlorpheniramine Maleate With Xylitol for the Treatment of Allergic Rhinitis.
PG  - e14206
LID - 10.7759/cureus.14206 [doi]
LID - e14206
AB  - The prevalence of allergic rhinitis (AR), including symptoms of sneezing, nasal 
      itching, airflow obstruction, and nasal discharge caused by histamine and 
      immunoglobulin E (IgE)-mediated reactions, is ~30% in the U.S. Recent studies 
      seem to suggest that the allergic inflammatory processes in AR may be induced by 
      the interaction between an allergen (trigger) and the nasal microbiome 
      (substrate). In this study, we have identified two agents with antihistaminic and 
      microbiome-modulating characteristics that can be administered intranasally, 
      namely, chlorpheniramine maleate (CPM) and xylitol (X). This study aimed to test 
      the efficacy of intranasal CPM plus xylitol (CPM+X) nasal for the treatment of AR 
      in an outpatient setting. A multicenter, randomized, double-blind, 30-day pilot 
      study was conducted during the spring of 2019. After starting five days of 
      placebo therapy (run-in period), patients with moderate-to-severe AR nasal 
      symptoms were randomized to treatment with CPM+X (n=16) spray and nasal saline 
      placebo (PLB; n=13). Both treatments were administered in the form of one spray 
      dose (~100 microL of the solution containing 1.25 mg CPM) per nostril twice a day. 
      Outcome variables were the changes in visual analog scale (VAS) and daily 
      symptoms score (DSS) at days 1, 5, 10, 15, 25, and 30 after the initiation of the 
      treatment. ANOVA (analysis of variance) with repeated revealed a significant 
      treatment-by-time interaction such that the CPM+X group had a significant 
      decrease (p < 0.05) in both DSS (∆-3.0 +/- 2.7) and VAS (∆-3.8 +/- 2.0) scores 
      compared to PLB after 30 days. The difference in DSS and VAS scores between the 
      groups was evident just after five days (day 10) of using CPM+X. The CPM+X scores 
      were significantly lower (p < 0.008) starting from day 10 compared with day 1, 
      whereas there were no statistically significant (p > 0.008) changes in the PLB 
      during the 30-day treatment window. The present data suggest that nasal CPM+X use 
      effectively improves AR symptoms. A large-scale study of the long-term effects of 
      CPM+X for the treatment of other chronic respiratory disorders and the potential 
      microbiome-modulating effects warrants further investigation.
CI  - Copyright (c) 2021, Sanchez-Gonzalez et al.
FAU - Sanchez-Gonzalez, Marcos
AU  - Sanchez-Gonzalez M
AD  - Graduate Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA.
FAU - Rizvi, Syed A
AU  - Rizvi SA
AD  - Graduate Medical Education, Larkin Community Hospital, South Miami, USA.
FAU - Torres, Joselit
AU  - Torres J
AD  - Asthma, Allergy and Immunology, Vargas Hospital Caracas, Caracas, VEN.
FAU - Ferrer, Gustavo
AU  - Ferrer G
AD  - Pulmonary Critical Care, Aventura Hospital and Medical Center, Aventura, USA.
LA  - eng
PT  - Journal Article
DEP - 20210331
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC8010914
OTO - NOTNLM
OT  - allergy
OT  - chlorpheniramine maleate
OT  - rhinitis
OT  - xylitol
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/04/06 06:00
MHDA- 2021/04/06 06:01
PMCR- 2021/03/31
CRDT- 2021/04/05 06:05
PHST- 2021/04/05 06:05 [entrez]
PHST- 2021/04/06 06:00 [pubmed]
PHST- 2021/04/06 06:01 [medline]
PHST- 2021/03/31 00:00 [pmc-release]
AID - 10.7759/cureus.14206 [doi]
PST - epublish
SO  - Cureus. 2021 Mar 31;13(3):e14206. doi: 10.7759/cureus.14206.