Comparison of ipratropium bromide 0.03% with beclomethasone dipropionate in the treatment of perennial rhinitis in children

Objective: To compare the safety and efficacy of ipratropium bromide 0.03% (IB) with beclomethasone dipropionate 0.042% (BDP) in the treatment of pere nnial rhinitis in children. Methods: Thirty-three children with nonallergic perennial rhinitis (NAPR) a nd 113 with allergic perennial rhinitis (APR) were randomly assigned to eit her IB or BDP for 6 months in a single-blind, multicenter protocol in which the physician was blinded to treatment. At each visit, patients and physic ians rated symptom control of rhinorrhea, nasal congestion, and sneezing. P atients also completed quality of life questionnaires at baseline and after 6 months of therapy. Results: Both treatments showed a significant improvement in control of rhi norrhea, congestion, and sneezing compared with baseline over the 6 months of treatment (P <.05). Only for the control of sneezing was BDP consistentl y better than IB (P <.05). Among the patients given IB, 61% to 73% assessed the control of rhinorrhea as good or excellent on different study visit da ys, 43% to 60% similarly rated the control of nasal congestion, and 39% to 43% the control of sneezing. The results for BDP were 68% to 78% for the co ntrol of rhinorrhea, 55% to 72% for the control of nasal congestion, and 54 % to 68% for the control of sneezing. Quality of life assessment documented that both drugs significantly reduced interference with daily activities a nd disturbance of mood due to rhinorrhea compared with baseline (P <.05). B oth treatments were well tolerated with IB causing less nasal bleeding and irritation than BDP. Conclusions: Ipratropium bromide was safe and effective in controlling rhin orrhea and diminishing the interference by rhinorrhea in school attendance, concentration on school work, and sleep. Ipratropium bromide was as effect ive as BDP in the control of rhinorrhea and showed a relatively good effect on congestion. Patient and physician assessment favored BDP in the control of sneezing.