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Comparative effect of beclomethasone dipropionate and cetirizine on acoustic rhinometry parameters in children with perennial allergic rhinitis: a randomized controlled trial

Malizia V1, Fasola S1,2, Ferrante G3, Cilluffo G1,2, Gagliardo R1, Landi M1,4, Montalbano L1,5, Marchese D1, La Grutta S1,3

1National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
2Department of Economics, Business and Statistical Science, University of Palermo, Italy
3Department of Science for Health Promotion and Mother and Child Care, University of Palermo, Italy
4National Healthcare System, ASL TO3, Turin, Italy
5Department of Psychology, University of Palermo, Italy

J Investig Allergol Clin Immunol 2018; Vol. 28(6)
doi: 10.18176/jiaci.0263

Background: The effect of intranasal corticosteroids and oral antihistamines on acoustic rhinometry parameters was not directly compared in previous studies.
Objectives: The primary aim was to compare the effect of 21-day treatment with nasal beclomethasone dipropionate (nBDP) versus cetirizine (CTZ) on nasal patency measured by acoustic rhinometry in children with PAR. Comparing their effect on nasal cytology, symptom severity, sleep quality and quality of life was the secondary aim.
Methods: In this 21-day, open-label, randomized controlled study, 34 PAR children (6–14 years) with Total 5 Symptom Score (T5SS) ≥5 received nBDP 100 µg per nostril twice daily or CTZ 10 mg tablets once daily. Effect measures were the least square mean changes (LSmc) in nasal volume and Minimal Cross-sectional Area (MCA), nasal cytology, T5SS, Pittsburgh Sleep Quality Index (PSQI) and Paediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ).
Results: After 21 days, nBDP improved nasal volume and MCA more than CTZ (LSmc 2.21 cm3 vs 0.20 cm3, p=0.013 and LSmc 0.63 cm2 vs 0.13 cm2, p=0.002, respectively). In the nBDP group, with respect to the CTZ group, larger improvement was found in: eosinophil (LSmc -1.10 vs -0.40, p=0.031) and neutrophil (LSmc -0.97 vs -0.17, p=0.010) classes, T5SS (LSmc -5.63 vs -3.54, p=0.008), PSQI (LSmc -1.30 vs -0.19, p=0.025) and PRQLQ total scores (LSmc -1.15 vs -0.69, p=0.031).
Conclusions: In children with PAR, nBDP is more effective than CTZ in improving nasal patency measured by acoustic rhinometry, with associated beneficial effects on nasal cytology, symptoms, sleep quality and quality of life.

Key words: Acoustic rhinometry, Allergic rhinitis, Beclomethasone dipropionate, Cetirizine, Children, Nasal patency