THE EFFICACY OF BUDESONIDE AND BECLOMETHASONE DIPROPIONATE, DELIVEREDVIA A PRESSURIZED METERED-DOSE INHALER, IN THE TREATMENT OF PERENNIALRHINITIS - A RANDOMIZED, DOUBLE-BLIND, CROSSOVER STUDY

A total of 28 adult patients (19 women, nine men, mean age 28.5 years, range 15-63 years) with a diagnosis of perennial allergic and nonalle rgic rhinitis (mean duration of symptoms 4.0 years, range 1-20 years) were recruited into this randomized, double-blind, crossover study. Ei ghteen patients (64%) were atopic for common allergens. The efficacy o f budesonide nasal aerosol (Rhinocort(R)) and beclomethasone dipropion ate (BDP; Beconase(R)) was compared using nominal doses of 200 mu g (b .i.d.) for each drug administered every morning and evening. Following a 2-week run-in period patients were ran domly-divided into two group s and treated for 4 weeks with either BDP or budesonide. After the cro ssover, patients then received the second drug for the remaining 4 wee ks of the trial. Response to the treatment regimens was assessed by su bjective symptom scoring and nasal peak expiratory flow rate (PEF) mea surements. Budesonide and BDP reduced all nasal symptom scores and imp roved nasal PEF compared to the run-in period. During budesonide thera py, significantly less sleep disturbance, lower evening and morning na sal blockage scores, and greater nasal PEF values in the evening were recorded than for BDP. Following crossover, patients who were treated with budesonide in the second part of the trial demonstrated significa ntly improved nasal blockage scores and evening nasal PEF in contrast to those who received BDP during the latter part of the study. The num ber of adverse events reported during the trial was equal for both dru gs and those noted tended to be mild. In conclusion although the sympt oms of perennial rhinitis were well controlled by both budesonide and BDP, the predominant symptom of nasal blockage was managed more effect ively with budesonide.