Research on Underlying Causes of Long-term Use of Nasal Decongestants and the Structured Withdrawal of the Decongestant
Status:
Suspended
Trial end date:
2022-07-31
Target enrollment:
Participant gender:
Summary
Rhinitis medicamentosa (RM) is a form of non-allergic medication-induced rhinitis
characterised by nasal congestion. This nasal congestion is the result of the overuse of
intranasal decongestants which leads to rebound congestion when the medication wears off.
This prompts the user of the nasal decongestant to administer more in order to obtain relief
from the feeling of a blocked nose. Therefore, the patient ends up in a vicious cycle caused
and temporarily relieved by the use of medication.The diagnosis of rhinitis medicamentosa
depends greatly on the history of prolonged use of the nasal decongestant, since real
diagnostic criteria have not yet been established. It is unclear if these patients suffer
from an underlying (undetected and/or untreated) nasal condition which might have caused the
patient to start using the nasal decongestant in the first place. Therefore, the aim of the
first part of this study (Part A) is to characterize patients with long-term use of nasal
decongestants to examine if an underlying nasal condition is present. The investigators will
include healthy volunteers in part A of the study to be able to compare their test results
with those of patients with long-term use of nasal decongestants and hence be able to detect
differences.
Thus far, the treatment of RM has been the topic of debate. Several treatment regimens have
been proposed in literature, but most study authors agree that it is essential to stop the
overuse of the nasal decongestant either immediately or gradually to limit withdrawal
symptoms. For this part of the study (Part B: intervention study), the investigators aim to
reduce the long-term use of nasal decongestants based on a structured withdrawal programme
comprising medication (nasal corticosteroid spray) and motivational interviewing. Only
patients with long-term use of nasal decongestants are eligible to participate in this part
of the study. They will be rescreened prior to inclusion into this part of the study.