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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) : 392-400
doi: 10.18176/jiaci.0263

Background: The effect of intranasal corticosteroids and oral antihistamines on acoustic rhinometry parameters has not been directly compared.
Objectives: The primary objective was to compare the effect of a 21-day course of treatment with nasal beclomethasone dipropionate (nBDP) with that of cetirizine (CTZ) on nasal patency measured using acoustic rhinometry in children with perennial allergic rhinitis (PAR). The secondary objective was to compare the effect of both drugs on nasal cytology, symptom severity, sleep quality, and quality of life.
Methods: In this 21-day, open-label, randomized controlled study, 34 children with PAR (age 6-14 years) with a Total 5-Symptom Score (T5SS) ≥5 received nBDP 100 μg per nostril twice daily or CTZ 10 mg tablets once daily. The measures of effect were the least square mean change (LSmc) in nasal volume, minimal cross-sectional area (MCA), and nasal cytology, as well as the scores on the 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=.013]; and LSmc 0.63 cm2 vs 0.13 cm2 [P=.002], respectively). Compared with the CTZ group, a more marked improvement was found in the nBDP group with respect to eosinophil classes (LSmc, –1.10 vs –0.40; P=.031) and neutrophil classes (LSmc, –0.97 vs –0.17; P=.010), T5SS (LSmc, –5.63 vs –3.54; P=.008), PSQI (LSmc, –1.30 vs –0.19; P=.025), and PRQLQ total scores (LSmc, –1.15 vs –0.69; P=.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