The Efficacy of Budesonide and Beclomethasone Dipropionate, Delivered via a Pressurized Metered Dose Inhaler, in the Treatment of Perennial Rhinitis: A Randomized, Double-Blind, Crossover Study

Abstract

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 nonallergic rhinitis (mean duration of symptoms 4.0 years, range 1–20 years) were recruited into this randomized, double-blind, crossover study. Eighteen patients (64%) were atopic for common allergens. The efficacy of budesonide nasal aerosol (Rhinocort®) and beclomethasone dipropionate (BDP; Beconase®) was compared using nominal doses of 200 μg (b.i.d.) for each drug administered every morning and evening. Following a 2-week run-in period, patients were randomly-divided into two groups and treated for 4 weeks with either BDP or budesonide. After the crossover, patients then received the second drug for the remaining 4 weeks of the trial. Response to the treatment regimens was assessed by subjective symptom scoring and nasal peak expiratory flow rate (PEF) measurements. Budesonide and BDP reduced all nasal symptom scores and improved nasal PEF compared to the run-in period. During budesonide therapy, significantly less sleep disturbance, lower evening and morning nasal 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 significantly improved nasal blockage scores and evening nasal PEF in contrast to those who received BDP during the latter part of the study. The number of adverse events reported during the trial was equal for both drugs and those noted tended to be mild. In conclusion, although the symptoms of perennial rhinitis were well controlled by both budesonide and BDP, the predominant symptom of nasal blockage was managed more effectively with budesonide.