A novel intranasal therapy of azelastine with fluticasone for the treatment of allergic rhinitis

Warner Carr* (Corresponding Author), Jonathan Bernstein, Phil Lieberman, Eli Meltzer, Claus Bachert, David Price, Ullrich Munzel, Jean Bousquet

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

202 Citations (Scopus)


Background: Moderate-to-severe allergic rhinitis (AR) is a challenge to treat, with many patients using multiple therapies and achieving limited symptom control. More effective therapies must be developed and tested in well-controlled, randomized, prospective studies with a direct comparison to current standards. Objectives: The aim of these studies was to investigate the efficacy of MP29-02 (a novel formulation of azelastine and fluticasone propionate [FP]) in patients with moderate-to-severe seasonal allergic rhinitis (SAR) and to compare its efficacy with 2 first-line therapies (ie, intranasal azelastine and intranasal FP) in this population. Methods: Three thousand three hundred ninety-eight patients (≥12 years old) with moderate-to-severe SAR were enrolled into 3 multicenter, randomized, double-blind, placebo- and active-controlled, parallel-group trials (MP4002 [NCT00651118], MP4004 [NCT00740792], and MP4006 [NCT00883168]). Each trial was conducted for 14 days during different allergy seasons. The primary efficacy variable was the sum of the morning and evening change from baseline in reflective total nasal symptom score (range, 0-24) over the treatment period. Outcomes for the meta-analysis included efficacy according to disease severity and time to response in relevant responder criteria. Results In the meta-analysis MP29-02 reduced the mean reflective total nasal symptom score from baseline (−5.7 [SD, 5.3]) more than FP (−5.1 [SD, 4.9], P <.001), azelastine (−4.4 [SD, 4.8], P <.001), or placebo (−3.0 [SD, 4.2], P <.001). This benefit was observed from the first day of assessment, with improvement in each individual nasal symptom, even in the patients with the most severe disease. MP29-02 achieved response consistently days earlier and showed greater efficacy in patients with moderate-to-severe rhinitis than FP and azelastine. Conclusions: MP29-02 represents a novel therapy that demonstrated superiority to 2 first-line therapies for AR. Patients with moderate-to-severe SAR achieved better control, and their symptoms were controlled earlier with MP29-02 than with recommended medications according to guidelines.
Original languageEnglish
Pages (from-to)1282-1289.e10
Number of pages18
JournalJournal of Allergy and Clinical Immunology
Issue number5
Early online date12 Mar 2012
Publication statusPublished - May 2012

Bibliographical note

These studies were funded by Meda Pharmaceuticals, Inc, and were designed to be consistent with recommendations provided in the US Food and Drug Administration guidance document for clinical development of drug products for allergic rhinitis (Guidance for Industry, US Department of Health and Human Services, US Food and Drug Administration Center for Drug Evaluation and Research; April 2000).


  • Allergic rhinitis
  • azelastine
  • fluticasone propionate
  • MP29-02
  • moderate-to-severe


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