Efficacy and Safety of Sea Salt-Derived Physiological Saline Nasal Spray as Add-On Therapy in Patients with Acute Upper Respiratory Infection: A Multicenter Retrospective Cohort Study

Abstract

Background The purpose of this study was to assess the effects of seawater on nasal congestion and runny nose symptoms in adults with an acute upper respiratory infection (URI). Material/Methods This was a multicenter retrospective cohort trial of patients with acute URI and symptoms of nasal congestion and runny nose. The patients were assigned to 2 groups and were administered regular non-drug supportive treatment or supportive treatment with nasal irrigation with sea salt-derived physiological saline. The primary efficacy endpoint was the effective rate (percentage of patients with ≥30% symptom score reduction from baseline for nasal congestion and runny nose). Results In total, 144 patients were enrolled, including 72 in each group, and 143 patients completed the study. Both groups had similar demographics and vital signs. The effective rates for nasal congestion and runny nose were significantly increased in the seawater group compared with patients in the control group (87.3% vs 59.7% for nasal congestion; 85.9% vs 61.1% for runny nose; both P <0.001). In addition, the 2 groups showed markedly different degrees of patient symptom score improvement in sleep quality and appetite (both P <0.01), but not in cough and fatigue (both P >0.05). There were no adverse events in either group. Conclusions The sea salt-derived physiological saline nasal spray device satisfactorily improved nasal congestion, runny nose, sleep quality, and appetite in adults with URI, with no adverse effects.

Physician Preferences and Prescribing Patterns for Hypertonic and Isotonic Saline Solutions in Upper Respiratory Symptom Management: A Multinational Clinical Practice Survey Across 13 Countries

“…Our findings provide additional evidence of physician enthusiasm for the seawater-based products, which reflects growing recognition of evidence-based natural alternatives in respiratory medicine [ 3 , 6 ]. Here, we document strong physician confidence in these approaches across diverse healthcare systems and practice settings.…”

“…Previous research has demonstrated that hypertonic saline nasal irrigation shows superior symptom improvement compared to isotonic solutions in allergic rhinitis, while isotonic saline irrigation provides meaningful benefits in chronic conditions [ 9 ]. A randomized controlled trial in children with perennial allergic rhinitis demonstrated that 3% hypertonic saline provided greater improvement in total nasal symptom scores than normal saline, particularly for nasal congestion [ 3 ]. A comprehensive systematic review and meta-analysis examined nine randomized controlled trials involving 740 patients and provided definitive evidence regarding the comparative effectiveness of hypertonic versus isotonic saline irrigation.…”

Physician Preferences and Prescribing Patterns for Hypertonic and Isotonic Saline Solutions in Upper Respiratory Symptom Management: A Multinational Clinical Practice Survey Across 13 Countries

“…Our findings provide additional evidence of physician enthusiasm for the seawater-based products, which reflects growing recognition of evidence-based natural alternatives in respiratory medicine [ 3 , 6 ]. Here, we document strong physician confidence in these approaches across diverse healthcare systems and practice settings.…”

“…Previous research has demonstrated that hypertonic saline nasal irrigation shows superior symptom improvement compared to isotonic solutions in allergic rhinitis, while isotonic saline irrigation provides meaningful benefits in chronic conditions [ 9 ]. A randomized controlled trial in children with perennial allergic rhinitis demonstrated that 3% hypertonic saline provided greater improvement in total nasal symptom scores than normal saline, particularly for nasal congestion [ 3 ]. A comprehensive systematic review and meta-analysis examined nine randomized controlled trials involving 740 patients and provided definitive evidence regarding the comparative effectiveness of hypertonic versus isotonic saline irrigation.…”

Effectiveness of intranasal saline cleansing methods for removal of particulate matter

“…25 Among adults with acute URTI, a higher proportion of those who regularly used nasal irrigation had ≥30% symptom score reduction from baseline in nasal congestion and runny nose compared with those who did not use nasal irrigation. 23 Mucociliary clearance times were significantly shortened after regular nasal saline washing in studies of individuals with rhinitis and sinusitis, 16,19 consistent with a benefit of removal of debris.…”

“…These findings are supported by the results of previous studies showing the importance of application angle for nasal spray deposition and demonstrating the clinical benefits of nasal saline washing. 15,16,19,[22][23][24][25][26] A study that evaluated the use of nasal casts constructed by 3D printing based on information from individual patient computed tomography scans found that deposition of cromolyn sodium spray in the turbinate region using a 30° angle of administration was enhanced by using patient-specific angles that accounted for individual patient characteristics. 22 A study using a 3D in vitro cell model of human airway epithelium (MucilAirTM-HF) exposed to pollutants (PM2.5-like diesel particulate matter and PM10like fine dust) showed that mechanical saline washing with Otrivin Natural Aloe Vera (Haleon [formerly GSK Consumer Healthcare]) improved measures of PM-induced deregulation of human nasal epithelial cells including restoring mucociliary clearance, maintaining tissue integrity, and lowering inflammatory mediators.…”

Real-World Safety and Performance of Saline Nasal Spray Products for Nasal Cleansing and Reducing Obstruction of the Nasal Cavity

“…Patients treated with nasal irrigation also reported having improved sleep, reduced stress, and improved health status compared with control patients [7]. Results from a multicenter, retrospective study of 144 adult patients with acute URTI showed that patients assigned to use of a sea-salt-derived saline nasal spray reported a ≥30% symptom score reduction from baseline in nasal congestion and runny nose, improved sleep quality, and improved appetite compared with those who did not use saline nasal spray [16]. This large body of clinical data on the effects of nasal saline administration has yielded consensus supporting the regular use of nasal saline sprays to help protect from airborne pathogens, pollutants, and allergens, and support respiratory health by reducing the impact of unpleasant stimuli in the nose [5] [17].…”

Physician Preferences and Prescribing Patterns for Hypertonic and Isotonic Saline Solutions in Upper Respiratory Symptom Management: A Multinational Clinical Practice Survey Across 13 Countries

“…Our findings provide additional evidence of physician enthusiasm for the seawater-based products, which reflects growing recognition of evidence-based natural alternatives in respiratory medicine [ 3 , 6 ]. Here, we document strong physician confidence in these approaches across diverse healthcare systems and practice settings.…”

“…Previous research has demonstrated that hypertonic saline nasal irrigation shows superior symptom improvement compared to isotonic solutions in allergic rhinitis, while isotonic saline irrigation provides meaningful benefits in chronic conditions [ 9 ]. A randomized controlled trial in children with perennial allergic rhinitis demonstrated that 3% hypertonic saline provided greater improvement in total nasal symptom scores than normal saline, particularly for nasal congestion [ 3 ]. A comprehensive systematic review and meta-analysis examined nine randomized controlled trials involving 740 patients and provided definitive evidence regarding the comparative effectiveness of hypertonic versus isotonic saline irrigation.…”

Effectiveness of intranasal saline cleansing methods for removal of particulate matter

“…25 Among adults with acute URTI, a higher proportion of those who regularly used nasal irrigation had ≥30% symptom score reduction from baseline in nasal congestion and runny nose compared with those who did not use nasal irrigation. 23 Mucociliary clearance times were significantly shortened after regular nasal saline washing in studies of individuals with rhinitis and sinusitis, 16,19 consistent with a benefit of removal of debris.…”

“…These findings are supported by the results of previous studies showing the importance of application angle for nasal spray deposition and demonstrating the clinical benefits of nasal saline washing. 15,16,19,[22][23][24][25][26] A study that evaluated the use of nasal casts constructed by 3D printing based on information from individual patient computed tomography scans found that deposition of cromolyn sodium spray in the turbinate region using a 30° angle of administration was enhanced by using patient-specific angles that accounted for individual patient characteristics. 22 A study using a 3D in vitro cell model of human airway epithelium (MucilAirTM-HF) exposed to pollutants (PM2.5-like diesel particulate matter and PM10like fine dust) showed that mechanical saline washing with Otrivin Natural Aloe Vera (Haleon [formerly GSK Consumer Healthcare]) improved measures of PM-induced deregulation of human nasal epithelial cells including restoring mucociliary clearance, maintaining tissue integrity, and lowering inflammatory mediators.…”

Real-World Safety and Performance of Saline Nasal Spray Products for Nasal Cleansing and Reducing Obstruction of the Nasal Cavity

“…Patients treated with nasal irrigation also reported having improved sleep, reduced stress, and improved health status compared with control patients [7]. Results from a multicenter, retrospective study of 144 adult patients with acute URTI showed that patients assigned to use of a sea-salt-derived saline nasal spray reported a ≥30% symptom score reduction from baseline in nasal congestion and runny nose, improved sleep quality, and improved appetite compared with those who did not use saline nasal spray [16]. This large body of clinical data on the effects of nasal saline administration has yielded consensus supporting the regular use of nasal saline sprays to help protect from airborne pathogens, pollutants, and allergens, and support respiratory health by reducing the impact of unpleasant stimuli in the nose [5] [17].…”

Physician Preferences and Prescribing Patterns for Hypertonic and Isotonic Saline Solutions in Upper Respiratory Symptom Management: A Multinational Clinical Practice Survey Across 13 Countries

“…Our findings provide additional evidence of physician enthusiasm for the seawater-based products, which reflects growing recognition of evidence-based natural alternatives in respiratory medicine [ 3 , 6 ]. Here, we document strong physician confidence in these approaches across diverse healthcare systems and practice settings.…”

“…Previous research has demonstrated that hypertonic saline nasal irrigation shows superior symptom improvement compared to isotonic solutions in allergic rhinitis, while isotonic saline irrigation provides meaningful benefits in chronic conditions [ 9 ]. A randomized controlled trial in children with perennial allergic rhinitis demonstrated that 3% hypertonic saline provided greater improvement in total nasal symptom scores than normal saline, particularly for nasal congestion [ 3 ]. A comprehensive systematic review and meta-analysis examined nine randomized controlled trials involving 740 patients and provided definitive evidence regarding the comparative effectiveness of hypertonic versus isotonic saline irrigation.…”

Effectiveness of intranasal saline cleansing methods for removal of particulate matter

“…25 Among adults with acute URTI, a higher proportion of those who regularly used nasal irrigation had ≥30% symptom score reduction from baseline in nasal congestion and runny nose compared with those who did not use nasal irrigation. 23 Mucociliary clearance times were significantly shortened after regular nasal saline washing in studies of individuals with rhinitis and sinusitis, 16,19 consistent with a benefit of removal of debris.…”

“…These findings are supported by the results of previous studies showing the importance of application angle for nasal spray deposition and demonstrating the clinical benefits of nasal saline washing. 15,16,19,[22][23][24][25][26] A study that evaluated the use of nasal casts constructed by 3D printing based on information from individual patient computed tomography scans found that deposition of cromolyn sodium spray in the turbinate region using a 30° angle of administration was enhanced by using patient-specific angles that accounted for individual patient characteristics. 22 A study using a 3D in vitro cell model of human airway epithelium (MucilAirTM-HF) exposed to pollutants (PM2.5-like diesel particulate matter and PM10like fine dust) showed that mechanical saline washing with Otrivin Natural Aloe Vera (Haleon [formerly GSK Consumer Healthcare]) improved measures of PM-induced deregulation of human nasal epithelial cells including restoring mucociliary clearance, maintaining tissue integrity, and lowering inflammatory mediators.…”

Real-World Safety and Performance of Saline Nasal Spray Products for Nasal Cleansing and Reducing Obstruction of the Nasal Cavity

“…Patients treated with nasal irrigation also reported having improved sleep, reduced stress, and improved health status compared with control patients [7]. Results from a multicenter, retrospective study of 144 adult patients with acute URTI showed that patients assigned to use of a sea-salt-derived saline nasal spray reported a ≥30% symptom score reduction from baseline in nasal congestion and runny nose, improved sleep quality, and improved appetite compared with those who did not use saline nasal spray [16]. This large body of clinical data on the effects of nasal saline administration has yielded consensus supporting the regular use of nasal saline sprays to help protect from airborne pathogens, pollutants, and allergens, and support respiratory health by reducing the impact of unpleasant stimuli in the nose [5] [17].…”