(1226) Efficacy of Personalized Multi-Ingredient Nasal Sprays in Patients With Rhinitis

Introduction: Evaluating clinical efficacy of personalized, multi-ingredient intranasal spray therapy for rhinitis symptoms.

Methods: This observational study was conducted from 1/11/2022 to 1/14/2026. A total of 15298 rhinitis patients aged >13 years meeting eligibility requirements completed an online 31-item intake questionnaire and post-treatment questionnaires 1 month after treatment initiation. Intake responses reviewed by a physician, who prescribed a personalized multi-ingredient nasal spray based on symptom profile. Formulations included FDA-approved medications— triamcinolone 0.055%-0.11%, azelastine 0.137%, ipratropium 0.015%-0.09% and low-dose oxymetazoline 0.003125%-0.0125%, compounded at 1 of 2 pharmacies. Post-treatment analysis utilized a Large Language Model (LLM) to categorize 9 symptoms into Improved, No Change, or Worsened: congestion, rhinorrhea, sneeze, itchy eyes, olfaction, ear symptoms, snore, sleep and energy/fatigue. One-sample Z-tests for proportions were used to compare improvement rates across symptoms against a conservatory efficacy threshold (60%), with symptomatology and prescribed spray composition as independent variables.

Results: Among reviews mentioning nasal congestion (n=7,813), 96.8% reported improvement. Improvement was also reported for sleep disruption (97.5%; n=1,895), sneezing (93.5%; n=620), and rhinorrhea (92.0%; n=1,030). Z-tests confirmed statistically significant improvement for all nine symptom sub-domains (p < 0.0001), with congestion and sleep showing the highest efficacy.

Conclusions: Analyses using Z-tests demonstrated statistical improvement across reported symptoms, including nasal congestion. These results support that personalized, multi-ingredient intranasal therapy is associated with significant improvement in the majority of patient-reported rhinitis symptoms. Future controlled studies with validated patient outcome measurements (RQLQ or TNSS) are warranted. Results should be interpreted within the context of potential non-response bias.