A study of the effect of nasal steroid sprays in perennial allergic rhinitis patients with rhinitis medicamentosa

OBJECTIVE. To determine if rebound congestion can be reduced with concomita nt nasal steroid spray usage. STUDY DESIGN AND SETTING: Randomized, double blind, controlled single cente r study. PARTICIPANTS: Twenty subjects with perennial allergic rhinitis wit h nasal congestion. INTERVENTION: All subjects received 3 weeks of twice-daily oxymetazoline. A fter 2 weeks, subjects were randomized to 2 additional weeks of concomitant budesonide aqueous nasal spray (n = 9) or placebo (n = 10). In the sixth w eek, all sprays were stopped. RESULTS., Both groups showed subjective and o bjective evidence of rebound congestion 24 hours after cessation of oxymeta zoline (P < 0.05). Subjective rebound congestion resolved in 48 hours in th e budesonide aqueous nasal spray group but persisted for over I week in the placebo group. CONCLUSION. Rebound congestion is objectively present in patients with pere nnial allergic rhinitis after 3 weeks of oxymetazoline spray. Rebound conge stion is reduced by concomitant budesonide aqueous nasal spray use. SIGNIFICANCE: This study supports the common clinical practice of nasal ste roid sprays to ameliorate rebound congestion concomitant with and after ces sation of topical decongestant sprays.