Overview

• A randomized, double-blind, placebo-controlled phase 2 study at Saarland University followed 450 healthy adults for 56 days using azelastine three times daily, with short bursts up to five times after exposure.
• PCR‑confirmed SARS‑CoV‑2 infections occurred in 2.2% of azelastine users versus 6.7% on placebo, with twice‑weekly rapid testing throughout the trial.
• Those on azelastine had fewer symptomatic COVID-19 cases, fewer overall respiratory infections, and a lower incidence of rhinovirus.
• The spray was generally well tolerated, with two serious adverse events reported in the azelastine group and none judged related to treatment; known minor effects include bitter taste and occasional nosebleeds.
• Findings come from a single-site cohort of mostly young, vaccinated adults and a product sponsored by URSAPHARM, leading independent experts to call for larger, diverse trials and evaluation in high‑risk groups.