Reduction of Metacholine‐Induced Nasal Secretion by Treatment with a New Topical Steroid in Perennial Non‐Allergic Rhinitis

Abstract

The value of three objective tests of the nasal mucosa in 22 patients with perennial non-allergic rhinitis treated with a topical corticosteroid has been investigated. Placebo and three different dosages of a new steroid, budesonide, were administered intranasally using a double-blind, cross-over technique. Nasal airway resistance was not reduced by the steroid treatment as compared with the placebo treatment. Eosinophilia in nasal smears was reduced by budesonide. However, the value of this test was decreased by the fact that eosinophilia was found in less than 50% of the patients at the beginning of the trial. Metacholine-induced nasal secretion was significantly reduced by the budesonide treatment. Symptom scores for nasal obstruction, secretion and sneezing attacks were also significantly reduced by the steroid.

An Objective Method to Record Changes in Nasal Reactivity during Treatment of Non-Allergic Nasal Hyperreactivity

“…This was also found in previous studies [7,[10][11][12][13]. In two of these studies, rhinomanometry was used as an indirect measure of changes in mucosal thickness after treatment with budesonide.…”

“…In one study [12] there is a tendency for lower NAR after treatment but no significant difference. In the other study [13], there was no significant difference between placebo and budesonide with regard to measure ments with rhinomanometry. However, there was a sig nificant difference in symptom score regarding nasal ob struction, and there were significant differences for the two other objective parameters; metacholine-induced 94 Hallén/Juto Changes in Nasal Hyperreactivity during Treatment nasal secretion and eosinophilia.…”

Acute dose‐response studies in bronchial asthma with a new corticosteroid, budesonide.

“…with chronic bronchial asthma (Ellul-Micallef et al, 1980b). The drug has since been further studied and favourably reported on in asthma (Willey et al, 1981), rhinitis (Balle et al, 1980;Pipkom et al, 1980;Malm et al, 1981) and in psoriasis (Agrup et al, 1981 Only patients with an FEV, < 80% of predicted normal value were admitted to the study. They were not adequately controlled by existing treatment and all showed a fair degree of stability in their condition.…”

Glucocorticosteroids and rhinitis

“…In the nose, a similar but weaker efl"ect of topical GCS treatment has been demonstrated in some (83,97,135,171,177), but not all studies (124). Thus, this modality appears to be more important in the bronchi than in the nose.…”