New Nasal Spray Approved for Nasal and Ocular Seasonal Allergic Rhinitis

Kate Johnson

September 07, 2022

Patients with both nasal and ocular symptoms of seasonal allergic rhinitis (SAR) have a new treatment option that combines olopatadine hydrochloride and mometasone furoate in the form of a nasal spray.

Ryaltris (Hikma Pharmaceuticals PLC and Glenmark Pharmaceuticals Ltd) is approved by the US Food and Drug Administration for adults and children aged 12 years and older and has an onset of action of within 15 minutes for nasal symptoms, according to a company press release.

"Allergic rhinitis and allergic conjunctivitis are among the most common chronic diseases in the US today, affecting 60 million Americans each year, yet approximately one in seven US adults have reported their nasal allergy symptoms are either poorly controlled or not controlled at all, and ocular symptoms are reported to be as severe as nasal symptoms," noted Leonard Bielory, MD, professor of medicine, allergy, immunology and ophthalmology at Hackensack Meridian School of Medicine, in the press release.

The spray combines two of the most frequently prescribed medications for these symptoms, Bielory added.

According to the press release, there is an important need for new treatment options for SAR, as uncontrolled symptoms can lead to chronic complications including asthma, sinusitis, hearing impairment, and other allergy-related complications. This may in turn require "therapy escalation to more costly and higher-risk treatments such as immunotherapy, biologics, and surgery," it noted.

Although Ryaltris is the first SAR nasal spray addressing both allergic rhinitis and rhinoconjunctivitis, it is the second combination nasal corticosteroid/antihistamine spray on the market, said Mark R. Neustrom, DO, an allergist-immunologist in Overland Park, Kansas. The first was Dymista (Meda Pharmaceuticals Inc), which is a combination of azelastine hydrochloride and fluticasone propionate.

"Both nasal antihistamines and nasal corticosteroid sprays have been shown to somewhat help with ocular itching via the nasoocular reflex," he told Medscape. "Significant ocular itching, however, is probably better addressed by using an allergy eye drop such as olopatadine eye drops OTC. Nasal antihistamines have the advantage [over pills] of fast onset of action, usually working within minutes, especially helping with early phase symptoms such as itchy, sneezy, runny nose," he added." Nasal corticosteroids are good at addressing late-phase allergic symptoms such as nasal congestion and post-nasal drainage. Together, the nasal antihistamine/nasal corticosteroid nasal spray provides relatively immediate symptom relief compared to pills."

Neustrom has disclosed no relevant financial relationships.

Kate Johnson is a Montreal-based freelance medical journalist who has been writing for more than 30 years about all areas of medicine.

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