A comparison of the efficacy and patient acceptability of budesonide and beclomethasone dipropionate aqueous nasal sprays in patients with perennial rhinitis.

This was an open, randomized, cross-over study comparing the efficacy and acceptability of aqueous nasal suspensions of budesonide, 200 micrograms b.i.d. and beclomethasone dipropionate (BDP), 100 micrograms q.i.d., each given for 6 weeks to patients with perennial rhinitis and a history of allergy. Forty men and women aged 18-65 years with perennial rhinitis diagnosed at least 1 year previously, were recruited for study provided they had at least two of the following symptoms of rhinitis--blocked nose, runny nose, itching nose or sneezing. They were requested to record the presence or absence of nasal and ocular symptoms on a severity scale of 0-3 (none, mild, moderate, severe) in daily diary cards. The sum of the nasal scores was calculated to give the total nasal symptom score. Mean individual symptom scores and total symptom score were calculated for each treatment. Thirty-seven patients completed the study. The mean total nasal symptom score was significantly lower during budesonide (2.13) than during BDP (2.75), P = 0.001. There were significantly fewer reports of blocked nose (P = 0.004), runny nose (P = 0.0005) and sore eyes (P = 0.047) during budesonide treatment compared with BDP. Four patients reported adverse events during budesonide treatment (two had nosebleeds and two nasal dryness) and three patients during BDP treatment (two had nasal dryness and one gastric discomfort). A significantly greater proportion of patients stated a preference for budesonide than for BDP on the basis of effect (P = 0.0001), side-effects (P = 0.01), and overall (P = 0.0001).