JAMA Network JAMA Internal Medicine : Azelastine Nasal Spray for Prevention of SARS-CoV-2 Infections
Sep 2, 2025
Azelastine nasal spray shows promise as a preventive treatment for COVID-19, according to a study involving nearly 600 participants. The experts discuss its significant reductions in infection rates and potential benefits against other respiratory viruses. A phase two study points to its efficacy as an antiviral treatment, though the need for larger trials is emphasized. The episode highlights its mechanisms and implications for at-risk populations, underscoring a hopeful advance in public health measures.
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From Hay Fever Spray To COVID Trial
- Robert Bals described how a preexisting azelastine nasal spray used for hay fever showed antiviral activity in lab tests.
- He then collaborated with the product maker and designed a prevention trial to test it in people.
Phase 2 Trial Shows Reduced COVID Risk
- The phase 2 randomized trial enrolled ~600 healthy participants and compared azelastine nasal spray to placebo.
- The spray reduced laboratory-confirmed COVID-19 infections and improved secondary endpoints like symptom load and duration.
Promising Effect Size, Needs Confirmation
- Dan Barouch emphasized the substantial effect size but reminded listeners this is a phase 2 study with relatively few events.
- He highlighted the potential value if larger phase 3 trials confirm broad antiviral activity against multiple respiratory viruses.