New combination nasal spray for allergic rhinitis

Ryaltris (olopatadine/mometasone) is indicated in adults and adolescents 12 years of age and older for the treatment of moderate to severe nasal symptoms associated with allergic rhinitis. It has a rapid onset of action within 15 minutes and can be given as first-line treatment. 

The usual recommended dose of Ryaltris is two actuations in each nostril twice daily (morning and evening).

Nasal symptoms

In 2 clinical studies in adults and adolescents 12 years of age or older with allergic rhinitis, two sprays of the fixed-dose olopatadine/mometasone combination in each nostril twice daily for 14 days improved nasal symptoms (rhinorrhoea, nasal congestion, sneezing and nasal itching) compared with placebo, olopatadine alone and mometasone alone.

In the first study (n=1180), the combination significantly improved average morning and evening 12 hr reflective Total Nasal Symptom Score (rTNSS) versus placebo (least squares mean difference −0.98 [95% CI −1.38 to −0.57]; p<0.001) and olopatadine (p=0.003), and approached statistical significance versus mometasone (p=0.059).

In the second study (n=1176), the combination produced statistically significant and clinically meaningful improvements in rTNSS versus placebo (least squares mean difference -1.09 [95% CI −1.49 to −0.69]; p<0.001), olopatadine (p=0.03) and mometasone (p=0.02).

Olopatadine/mometasone also significantly improved overall ocular symptoms and quality of life compared with placebo in both studies.

The adverse reactions most commonly reported during treatment with olopatadine/mometasone were dysgeusia, epistaxis and nasal discomfort. 

Ryaltris is the second antihistamine/corticosteroid nasal spray to be launched in the UK after Dymista, which is approved for second-line use when an intranasal antihistamine or steroid alone is inadequate.

Prescribers can compare nasal, ophthalmic and systemic hayfever treatments with a quick-reference MIMS comparison table.