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CompletedNCT04853836Updated Nov 16, 2022

Olfactory Disfunction and Co-ultraPEALut

A Phase 4 interventional study of co-ultraPEALut and Olfactory Rehab in Anosmia, Covid19 and Hyposmia, sponsored by University Of Perugia. Completed at 1 site in Italy. Open to participants aged 18 Years to 85 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-11-16.

Sponsored by University Of Perugia · Phase 4, Interventional, and Treatment

From the registry’s dates

  • Registered 5 months after the study started (first participant enrolled Nov 2020, registered Apr 2021).
Phase
Phase 4
Study type
Interventional
Enrollment
200
Allocation
Randomized
Ages
18 Years to 85 Years
Sex
All
01

Study summary

Olfactory dysfunction is common among patients with Corona-Virus-Infection-Disease (COVID)-19, and up to 30% of patients may report persistent disorders of smell or taste as a long-term sequelae. This randomized-controlled study has addressed to compare the efficacy of neuro-protective and anti-inflammatory agents palmitoylethanolamide (PEA) and Luteolin(Treatment) with control (olfactory training) in a cohort of patients who present persistent smell disorders after resolution from Covid-19 and negative swab for 4 months at least.

Read the detailed description

Patients ages 18 to 70 years with confirmed history of COVID-19 (positive nasopharyngeal swab for SARS-CoV-2) and subjective olfactory dysfunction persisting ≥ 90 days after follow-up negative COVID-19 nasopharyngeal swab are eligible.

All patients will undergo nasal endoscopic examination to look for presence of polyps, masses, anatomic blockage, or other pathology which presence will require exclusion from the study. Patients then will be evaluated at the baseline with Sniffin' Sticks (Burghardt®, Wedel, Germany) prior to initiating olfactory training and/or supplement treatment (T0). One group received daily olfactory training, patients in the supplement group additionally received a daily oral tablet that contained PEA 700 mg and Luteolin 70 mg (Glialia ®, Epitech pharmaceutical, Milano, Italy), or 1 dose of PEA-LUT only or aTwo Dose of PEA-LUT.

Assessment of olfactory function will be repeated at 30 days, 60 and 90 and 120 days

02

Conditions studied

  • Anosmia
  • Covid19
  • Hyposmia
  • Parosmia
  • Treatment Compliance
03

In context

Anosmia

180 studies on the registry are indexed under Anosmia; 45 are open to participants now.

This study's enrollment of 200 is above the median of 60 across 114 interventional studies indexed under Anosmia.

Browse Anosmia studies →

Lead sponsor

University Of Perugia is the lead sponsor of 55 studies on the registry; 12 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • 18 to 90 years with confirmed history of COVID-19 (positive nasopharyngeal swab for SARS-CoV-2)
  • subjective olfactory dysfunction persisting ≥ 90 days after follow-up negative COVID-19 nasopharyngeal swab

Exclusion criteria

Exclusion Criteria:

  • previous history of olfactory-gustatory disorders
  • impaired cognitive function
  • history of neurodegenerative disease
  • medical therapy with possible effects on olfactory function
  • presence of rhinological disorders (sinusitis, rhinosinusitis, sinonasal polyposis, atrophic rhinitis, allergy)
  • history of chemo-radiotherapy of the head and neck region
  • history of stroke or neurotrauma
  • severe nasal blockage from stenosis of deformity
  • severe psychiatric illness (e.g. schizophrenia, bipolar disorder, olfactory hallucination)
  • previous sinonasal
  • nasopharyngeal tumors.
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
200 participants (actual)

Study arms

  • Placebo comparator
    Rehabilitation therapy only (control group)

    Olfactory training / stimulation through Sniffin' Sticks, administered twice every day (10 minutes session)

    Procedure: Olfactory Rehab

  • Active comparator
    Rehabilitation and treatment with PEA-LUT

    Olfactory training / stimulation through Sniffin' Sticks, plus daily treatment with PEA/Luteolin oral supplement

    Combination Product: co-ultraPEALut

  • Active comparator
    Treatment with PEA-LUT one sachet daily

    Patients in this group only used a single dose of PEA-LUT

    Drug: PEA-LUT 1 sachet

  • Active comparator
    Treatment with PEA-LUT two sachet daily

    Patients in this group only used two doses of PEA-LUT

    Drug: PEA-LUT 2 sachet day

Interventions

  • Combination productco-ultraPEALut

    Olfactory rehab 10 minutes twice a day for all the observation period + co-ultraPEALut (700 PEA + 70 Luteolin) 1 dose daily.

  • ProcedureOlfactory Rehab

    Olfactory Rehabilitation10 minutes twice a day for all the observation period

  • DrugPEA-LUT 1 sachet

    Only 1 sachet day of PEA-LUT no olfactory training

  • DrugPEA-LUT 2 sachet day

    2 sachets day of PEA-LUT no olfactory training

06

What researchers measure

Primary outcomes

  1. Recovery of smell

    Change of Sniff scores from T0.The Sniffin' Sticks battery was administered following a previously established protocol, using pen-like devices filled with odorants.Three score subtests were conducted to measure olfactory function: 1. detection threshold ("T", the lowest concentration at which an odor can be perceived), 2. odor discrimination ("D", ability to distinguish between odors) and 3. odor identification ("I" ability to assign names to odors). Possible scores ranged from 1-16 for the detection threshold subtest and 0-16 for both the discrimination and identification subtests. Adding these for yielded a TDI "Sniff score." Anosmia was defined as a score of \<17, hyposmia by a score 17 to 30.75, and normosmia by a score of ≥31

    Time frame: T1 (30 days), T2 (60 days), T3 (90 days)

Secondary outcomes

  1. Parosmia after treatment

    Prevalence of anosmia among the groups in the recovery

    Time frame: 60 days (T2) and 90 days (T3)

07

Study locations

1 site
  • Multicentric
    Roma, Italy
08

References and documents

Publications

  • Ralli M, Di Stadio A, Greco A, de Vincentiis M, Polimeni A. Defining the burden of olfactory dysfunction in COVID-19 patients. Eur Rev Med Pharmacol Sci. 2020 Apr;24(7):3440-3441. doi: 10.26355/eurrev_202004_20797. No abstract available. PubMed 32329813 ↗
  • Meinhardt J, Radke J, Dittmayer C, Franz J, Thomas C, Mothes R, Laue M, Schneider J, Brunink S, Greuel S, Lehmann M, Hassan O, Aschman T, Schumann E, Chua RL, Conrad C, Eils R, Stenzel W, Windgassen M, Rossler L, Goebel HH, Gelderblom HR, Martin H, Nitsche A, Schulz-Schaeffer WJ, Hakroush S, Winkler MS, Tampe B, Scheibe F, Kortvelyessy P, Reinhold D, Siegmund B, Kuhl AA, Elezkurtaj S, Horst D, Oesterhelweg L, Tsokos M, Ingold-Heppner B, Stadelmann C, Drosten C, Corman VM, Radbruch H, Heppner FL. Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19. Nat Neurosci. 2021 Feb;24(2):168-175. doi: 10.1038/s41593-020-00758-5. Epub 2020 Nov 30. PubMed 33257876 ↗
  • Levy JM. Treatment Recommendations for Persistent Smell and Taste Dysfunction Following COVID-19-The Coming Deluge. JAMA Otolaryngol Head Neck Surg. 2020 Aug 1;146(8):733. doi: 10.1001/jamaoto.2020.1378. No abstract available. PubMed 32614399 ↗
  • D'Ascanio L, Pandolfini M, Cingolani C, Latini G, Gradoni P, Capalbo M, Frausini G, Maranzano M, Brenner MJ, Di Stadio A. Olfactory Dysfunction in COVID-19 Patients: Prevalence and Prognosis for Recovering Sense of Smell. Otolaryngol Head Neck Surg. 2021 Jan;164(1):82-86. doi: 10.1177/0194599820943530. Epub 2020 Jul 14. PubMed 32662745 ↗
  • Chiu A, Fischbein N, Wintermark M, Zaharchuk G, Yun PT, Zeineh M. COVID-19-induced anosmia associated with olfactory bulb atrophy. Neuroradiology. 2021 Jan;63(1):147-148. doi: 10.1007/s00234-020-02554-1. Epub 2020 Sep 15. PubMed 32930820 ↗
  • Laurendon T, Radulesco T, Mugnier J, Gerault M, Chagnaud C, El Ahmadi AA, Varoquaux A. Bilateral transient olfactory bulb edema during COVID-19-related anosmia. Neurology. 2020 Aug 4;95(5):224-225. doi: 10.1212/WNL.0000000000009850. Epub 2020 May 22. No abstract available. PubMed 32444492 ↗
  • Lee MH, Perl DP, Nair G, Li W, Maric D, Murray H, Dodd SJ, Koretsky AP, Watts JA, Cheung V, Masliah E, Horkayne-Szakaly I, Jones R, Stram MN, Moncur J, Hefti M, Folkerth RD, Nath A. Microvascular Injury in the Brains of Patients with Covid-19. N Engl J Med. 2021 Feb 4;384(5):481-483. doi: 10.1056/NEJMc2033369. Epub 2020 Dec 30. No abstract available. PubMed 33378608 ↗
  • Stoyanov GS, Petkova L, Dzhenkov DL, Sapundzhiev NR, Todorov I. Gross and Histopathology of COVID-19 With First Histology Report of Olfactory Bulb Changes. Cureus. 2020 Dec 4;12(12):e11912. doi: 10.7759/cureus.11912. PubMed 33415060 ↗
  • Skaper SD, Facci L, Giusti P. Glia and mast cells as targets for palmitoylethanolamide, an anti-inflammatory and neuroprotective lipid mediator. Mol Neurobiol. 2013 Oct;48(2):340-52. doi: 10.1007/s12035-013-8487-6. Epub 2013 Jun 28. PubMed 23813098 ↗
  • Paniz-Mondolfi A, Bryce C, Grimes Z, Gordon RE, Reidy J, Lednicky J, Sordillo EM, Fowkes M. Central nervous system involvement by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). J Med Virol. 2020 Jul;92(7):699-702. doi: 10.1002/jmv.25915. PubMed 32314810 ↗
  • Guida F, Luongo L, Boccella S, Giordano ME, Romano R, Bellini G, Manzo I, Furiano A, Rizzo A, Imperatore R, Iannotti FA, D'Aniello E, Piscitelli F, Sca Rossi F, Cristino L, Di Marzo V, de Novellis V, Maione S. Palmitoylethanolamide induces microglia changes associated with increased migration and phagocytic activity: involvement of the CB2 receptor. Sci Rep. 2017 Mar 23;7(1):375. doi: 10.1038/s41598-017-00342-1. PubMed 28336953 ↗
  • Tan D, Yu X, Chen M, Chen J, Xu J. Lutein protects against severe traumatic brain injury through anti-inflammation and antioxidative effects via ICAM-1/Nrf-2. Mol Med Rep. 2017 Oct;16(4):4235-4240. doi: 10.3892/mmr.2017.7040. Epub 2017 Jul 20. PubMed 28731190 ↗
  • O'Byrne L, Webster KE, MacKeith S, Philpott C, Hopkins C, Burton MJ. Interventions for the treatment of persistent post-COVID-19 olfactory dysfunction. Cochrane Database Syst Rev. 2022 Sep 5;9(9):CD013876. doi: 10.1002/14651858.CD013876.pub3. PubMed 36062970 ↗

Individual participant data

Plan to share: Yes — Shared, only anonymized data directly requested to PI

Supporting information: Study protocol, Statistical analysis plan

Access criteria: request to PI

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 16, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04853836
Lead sponsor
University Of Perugia
Collaborators
Azienda Ospedaliera Ospedali Riuniti Marche Nord, Italy, Federico II University, Humanitas Hospital, Italy, San Giovanni Addolorata Hospital, Policlinico Universitario, Catania, Azienda Ospedaliero-Universitaria Careggi, Azienda Ospedaliero Universitaria di Sassari, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone Palermo, Ospedale Universitario di Genova, Italy, Istituto per la Sicurezza Sociale (ISS) della Repubblica di San Marino, Ospedale Bufalini di Cesena, Italy
Responsible party
Arianna Di Stadio (Adjunct Professor, University Of Perugia) — Principal investigator
First posted
Apr 21, 2021
Start date
Nov 15, 2020
Primary completion
Oct 28, 2021
Completion
Aug 31, 2022
Last update
Nov 16, 2022

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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