ciclesonide + placebo azelastine

This is a combination therapy consisting of ciclesonide nasal spray and a placebo version of azelastine nasal spray. Ciclesonide is a synthetic glucocorticoid corticosteroid administered as a pro-drug, which is enzymatically converted in the body to its active metabolite, des-ciclesonide. It acts primarily as an agonist at the glucocorticoid receptor, exerting anti-inflammatory effects by inhibiting leukocyte infiltration, suppressing humoral immune responses, and interfering with inflammatory mediators such as histamine and cytokines. The combination was studied in clinical trials for perennial allergic rhinitis to assess whether adding ciclesonide to placebo azelastine (as opposed to active azelastine) provides therapeutic benefit for patients not adequately controlled on monotherapy[1][2][3][4].