CompletedPhase 4

Omega-3-Based Nutraceutical Supplementation as Adjunctive Therapy in Adults With Otitis Media With Effusion: A Multicenter, Double-Blind, Randomized Placebo-Controlled Trial

Italy501 participantsStarted 2025-10-01

Plain-language summary

Brief Summary - OMENUTS Trial Otitis media with effusion (OME) is a condition in which fluid accumulates in the middle ear, causing conductive hearing loss, ear fullness, tinnitus, and Eustachian tube dysfunction. Although OME is well-recognized in children, it also affects adults, in whom it is frequently under-diagnosed and inadequately treated. No established, well-tolerated pharmacological therapy currently exists for adult OME, and current medical management options - including antihistamines, corticosteroids, and mucolytics - have shown inconsistent efficacy in clinical trials. Omega-3 polyunsaturated fatty acids and associated nutraceutical compounds have well-documented anti-inflammatory and immunomodulatory properties that are mechanistically relevant to the pathophysiology of OME, which is driven by chronic low-grade mucosal inflammation, Eustachian tube dysfunction, and impaired mucociliary clearance. A nutraceutical combination containing omega-3 fatty acids, Spirulina, magnesium, and vitamin B6 has previously demonstrated efficacy in reducing inflammatory biomarkers and improving clinical outcomes in allergic rhinitis - a condition sharing key pathophysiological features with OME. The OMENUTS trial is a multicenter, double-blind, randomized placebo-controlled trial designed to evaluate the efficacy of this nutraceutical combination as adjunctive therapy in adults with confirmed OME. The trial is conducted across three tertiary referral centres in Italy: Isola Tiberina - Gemelli Isola Hospital (Rome), the University of Catanzaro (Catanzaro), and Tortorella Clinic (Salerno). A total of 501 adult participants aged 18 to 70 years with a confirmed diagnosis of OME - established by otoscopic examination and tympanometry (type B curve) of at least 4 weeks' duration - are randomized in a 1:1:1 ratio to one of three groups. All participants receive a shared background therapy of intranasal mometasone furoate spray and oral deflazacort for three weeks. In addition to the background therapy, participants in Group 1 (intervention group) receive the nutraceutical combination (omega-3 fatty acids, Spirulina, magnesium, and vitamin B6; one tablet daily) for three weeks; participants in Group 2 (active control group) receive oral bilastine 20 mg daily for three weeks; and participants in Group 3 (placebo group) receive an identical placebo tablet daily for three weeks. The co-primary outcomes are tympanometric resolution - defined as normalization of the tympanometric curve from type B to type A - and audiometric improvement - defined as a reduction in pure-tone average of more than 15 dB HL - both assessed at the end of treatment (week 3, T1). Secondary outcomes include changes in patient-reported symptom severity (VAS), Eustachian tube dysfunction symptoms (ETDQ-7), psychosocial impact of hearing impairment (HHIA), and Eustachian tube patency assessed by the Valsalva maneuver. A 60-day post-treatment follow-up visit (T2) is included to evaluate recurrence rates across groups. Randomization is computer-generated via REDCap, stratified by site, and implemented with permuted blocks of variable size. The trial is conducted under a double-blind design, with all investigational products identical in appearance, odour, and taste. Safety outcomes, including the incidence and nature of adverse events classified according to MedDRA criteria, are monitored continuously throughout the study. The primary analysis is conducted on a modified intention-to-treat basis, including all participants who received at least one dose of the assigned treatment and completed at least one post-baseline assessment. The trial is conducted in accordance with the Declaration of Helsinki, CONSORT guidelines, and was approved by the Institutional Review Board of the Region of Calabria, Italy (approval code: 177/2026).

Who can participate

Age range

18 Years – 70 Years

Sex

ALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * Age 18 to 70 years * Confirmed diagnosis of unilateral or bilateral otitis media with effusion (OME), established by otoscopic examination and tympanometry (type B curve) * Duration of symptoms of at least 4 weeks prior to enrollment * Ability to provide written informed consent * Willingness to comply with the study protocol and attend all scheduled visits Exclusion Criteria: Pregnancy or breastfeeding Uncontrolled asthma Chronic obstructive or restrictive pulmonary disease Autoimmune or connective tissue disease Acute sinusitis or acute upper respiratory tract infection at the time of enrollment Cardiovascular, hepatic, or renal disease Use of medications known to affect immune response History of nasal or sinus surgery Receipt of immunotherapy within 3 years prior to enrollment or planned immunotherapy during the study period Any other condition that, in the investigator's judgement, would preclude safe participation or compromise the integrity of the trial

Questions worth asking your doctor

Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.

1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?

Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.

Questions for the trial coordinator

The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.

1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?

A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.

What they're measuring

Tympanometric resolution

Timeframe: Week 3 (end of treatment, T1)

Audiometric improvement

Timeframe: Week 3 (end of treatment, T1)

Trial details

NCT IDNCT07721610

SponsorIsola Tiberina - Gemelli Isola Hospital, Rome, Italy

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2026-04-01

View on ClinicalTrials.gov More Otits Media With Effusion trials