title: The effects of a TRPV1 antagonist, SB-705498, in the treatment of seasonal allergic rhinitis.
abstract: BACKGROUND
  Current pharmacotherapy for allergic rhinitis (AR) does not totally ameliorate all symptoms for all patients. Residual symptoms could be due to nasal neuronal hyperresponsiveness caused by stimulation of the ion channel transient receptor potential vanilloid 1 (TRPV1). SB-705498 is a TRPV1 antagonist that has been developed in an intranasal formulation for treatment of AR.
  
  
  METHODS
  This randomized, double-blind, 3-way incomplete block crossover study evaluated the effects of 8 days treatment with SB-705498 12 mg alone, SB-705498 12 mg plus fluticasone propionate 200 μg (FP), FP 200 μg alone or placebo on allergen-induced symptoms in 70 patients with AR. The primary endpoint was total nasal symptom score (TNSS), expressed as mean over 4 hours or maximum TNSS during allergen challenge in the Vienna Challenge Chamber on 8th day of treatment.
  
  
  RESULTS
  At the end of treatment, there were no differences in allergen-induced mean TNSS between SB-705498 alone and placebo or between SB-705498 plus FP and FP alone. Treatment with FP and SB-705498 plus FP resulted in a significant decrease in TNSS vs. placebo. Mean (90% CI) treatment differences in TNSS over 0 - 4 hours were: SB-705498 - placebo: -0.2 (-0.9, 0.4); SB-705498 plus FP - FP: 0.7 (0.2, 1.2); FP - placebo: -2.9 (-3.4, -2.5); SB-705498 plus FP - placebo: -2.3 (-2.8, -1.8). SB-705498 had no impact on diary card symptoms, nasal airflow or Rhinoconjunctivitis Quality of Life Questionnaire scores. SB-705498 was well tolerated and pharmacokinetics exposure results supported the dosing regimen.
  
  
  CONCLUSIONS
  SB-705498 12 mg for 8 days did not alleviate the allergen-induced symptoms of AR, or provide additional relief of symptoms when in combination with FP. Despite engagement of the TRPV1 receptor there was no translation to clinical efficacy, suggesting redundancy in symptom pathways.
authors.affiliation: GlaxoSmithKline, Stevenage, UK.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bareille
authors.forename: Robert D
authors.initials: RD
authors.lastname: Murdoch
authors.forename: Jane
authors.initials: J
authors.lastname: Denyer
authors.forename: Jane
authors.initials: J
authors.lastname: Bentley
authors.forename: Kevin
authors.initials: K
authors.lastname: Smart
authors.forename: Katy
authors.initials: K
authors.lastname: Yarnall
authors.forename: Petra
authors.initials: P
authors.lastname: Zieglmayer
authors.forename: René
authors.initials: R
authors.lastname: Zieglmayer
authors.forename: Patrick
authors.initials: P
authors.lastname: Lemell
authors.forename: Friedrich
authors.initials: F
authors.lastname: Horak
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000730:Androstadienes / Q000627:therapeutic use; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001317:Austria; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D011759:Pyrrolidines / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D050916:TRPV Cation Channels / Q000037:antagonists & inhibitors* / Q000378:metabolism; D016896:Treatment Outcome; D014508:Urea / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D000730:Androstadienes; D018926:Anti-Allergic Agents; D011759:Pyrrolidines; C512301:SB 705498; D050916:TRPV Cation Channels; C494482:TRPV1 protein, human; D014508:Urea; D000068298:Fluticasone