Study Evaluating the Safety of Intranasal Administration of 400 μg of Fluticasone Propionate Twice a Day (BID) Using a Novel Bi-Directional Device in Subjects With Chronic Sinusitis With or Without Nasal Polyps
Condition: Chronic Sinusitis With or Without Nasal Polyps
MeSH terms: Sinusitis; Nasal Polyps; Polyps; Chronic Disease
Intervention: Fluticasone Propionate
Intervention description: Fluticasone Propionate 400 μg
Intervention MeSH terms: Fluticasone; Xhance
Phase: Phase 3
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 705.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No

Summary:

      This is an open-label, multicenter study designed to assess the safety of intranasal
      administration of 400 μg of fluticasone propionate twice a day delivered by the OptiNose
      device in subjects with chronic sinusitis with or without nasal polyps. The study consists of
      an up-to-7-day pretreatment phase followed a 3-month open-label treatment phase. The duration
      of each subject's participation is approximately 13 weeks.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Men or women aged 18 years and older

          -  Women must

               -  be practicing an effective method of birth control (eg, prescription oral
                  contraceptives, contraceptive injections, contraceptive patch, intrauterine
                  device, double-barrier method [eg, condoms, diaphragm, or cervical cap with
                  spermicidal foam, cream, or gel], or male partner sterilization) before entry and
                  throughout the study, or

               -  be surgically sterile (have had a hysterectomy or bilateral oophorectomy, or
                  tubal ligation at least 1 year before screening) or otherwise be incapable of
                  pregnancy, or

               -  be postmenopausal (spontaneous amenorrhea for at least 1 year).

          -  Women of child-bearing potential must have a negative serum beta-human chorionic
             gonadotropin (β-hCG) pregnancy test at the screening visit

          -  Have either:

        a history of chronic sinusitis with bilateral nasal polyposis determined by nasoendoscopy
        at screening visit OR a history of chronic sinusitis (without polyps) for equal to or
        greater than 12 weeks and currently experiencing 2 or more of the following symptoms, one
        of which MUST be either nasal blockage/congestion or nasal discharge (anterior and/or
        posterior nasal discharge):

          1. nasal blockage/congestion

          2. nasal discharge (anterior and/or posterior nasal discharge)

          3. facial pain or pressure

          4. reduction or loss of smell

               -  Subjects with comorbid asthma or COPD must be stable with no exacerbations (eg,
                  no emergency room visits, hospitalizations, or oral or parenteral steroid use)
                  within the 3 months before the screening visit. Inhaled corticosteroid use must
                  be limited to stable doses of no more than 1,000 μg/day of beclomethasone (or
                  equivalent; See Attachment 1) for at least 3 months before screening with plans
                  to continue use throughout the study.

               -  Must be able to cease treatment with intranasal steroids and inhaled
                  corticosteroids (except permitted doses listed above for asthma and COPD) at the
                  screening visit

               -  Must be able to use the OptiNose device correctly; all subjects will be required
                  to demonstrate correct use of the placebo device at the screening visit, see
                  Section 12.1, Visit 1, screening procedures.

               -  Must be capable, in the opinion of the investigator, of providing informed
                  consent to participate in the study. Subjects must sign an informed consent
                  document indicating that they understand the purpose of and procedures required
                  for the study and are willing to participate in the study

        Exclusion Criteria:

          -  Women who are pregnant or lactating

          -  Inability to have each nasal cavity examined for any reason, including nasal septum
             deviation

          -  Nasal septum perforation

          -  Has had more than 1 episode of epistaxis with frank bleeding in the month before the
             screening visit

          -  Have evidence of significant baseline mucosal injury, ulceration or erosion (eg,
             exposed cartilage, perforation) on baseline nasal examination/nasoendoscopy

          -  History of sinus or nasal surgery within 6 months before the screening visit

          -  Current, ongoing rhinitis medicamentosa (rebound rhinitis)

          -  Have significant oral structural abnormalities, eg, a cleft palate

          -  Diagnosis of cystic fibrosis

          -  History of Churg-Strauss syndrome or dyskinetic ciliary syndromes

          -  Purulent nasal infection, acute sinusitis, or upper respiratory tract infection within
             2 weeks before the screening visit. Potential subjects presenting with any of these
             infections may be rescreened 4 weeks after symptom resolution

          -  Planned sinonasal surgery during the period of the study

          -  Allergy, hypersensitivity, or contraindication to corticosteroids or steroids

          -  Allergy or hypersensitivity to any excipients in study drug

          -  Exposure to any glucocorticoid treatment with potential for systemic effects (eg,
             oral, parenteral, intra-articular, or epidural steroids, high dose topical steroids)
             within 1 month before the screening visit; except as noted in inclusion criteria for
             subjects with comorbid asthma or COPD

          -  Have nasal candidiasis

          -  Have taken a potent CYP3A4 inhibitor within 14 days before the screening visit;
             examples of these medications can be found in Section 11.6, Concomitant Medication.

          -  History or current diagnosis of any form of glaucoma or ocular hypertension (ie,
             intraocular pressure >21 mmHg)

          -  History of intraocular pressure elevation on any form of steroid therapy

          -  History or current diagnosis of the presence (in either eye) of a cataract

          -  Any serious or unstable concurrent disease, psychiatric disorder, or any significant
             condition that, in the opinion of the investigator could confound the results of the
             study or could interfere with the subject's participation or compliance in the study

          -  A recent (within 1 year of the screening visit) clinically significant history of drug
             or alcohol use, abuse, or dependence that, in the opinion of the investigator could
             interfere with the subject's participation or compliance in the study

          -  Positive urine drug screen at screening visit for drugs of abuse (see Section 14.5),
             with the exception of prescribed medications for legitimate medical conditions

          -  Have participated in a previous clinical trial of OPTINOSE FLUTICASONE

          -  Have participated in an investigational drug clinical trial within 30 days of the
             screening visit

          -  Employees of the investigator or study center, with direct involvement in the proposed
             study or other studies under the direction of that investigator or study center, as
             well as family members of the employees or the investigator