NASAL INHALATION OF BUDESONIDE FROM A SPACER IN CHILDREN WITH PERENNIAL RHINITIS AND ASTHMA

The standard treatment of allergic rhinitis and asthma consists of top ical corticosteroids administered intranasally and inhaled through the mouth. Although this therapy is highly effective, and side-effects ar e few and mild, it may be possible further to improve the therapeutic index and patient compliance with the treatment. In the present study, we evaluated a nasal inhalation system used for the simultaneous trea tment of rhinitis and asthma. In principle, it results in an airway de position of the corticosteroid similar to that of inhaled allergens. T wenty-four children with perennial rhinitis and asthma inhaled budeson ide through the nose from a pressurized aerosol, attached to a spacer device, in a double-blind, placebo-controlled, crossover study. Compar ed with placebo, budesonide treatment resulted in a significant reduct ion of nasal symptoms (P<0.01) and of asthma symptoms (P<0.05), and in an increase of nasal peak inspiratory flow (P<0.001) and of oral peak expiratory flow (P=0.01). There were no differences between budesonid e and placebo in local side-effects, such as dry nose, nosebleed, and hoarseness. We conclude that nasal inhalation of a corticosteroid from a spacer offers a simple and effective treatment for both rhinitis an d asthma in children, but it is an open question whether the nasal inh alation system can improve the ratio of antirhinitis/antiasthma effect s to side-effects.