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Naclerio, R.M. et al.

Naclerio, Baroody, Bidani, De Tineo, Penney,

A comparison of nasal clearance after treatment of perennial allergic rhinitis with budesonide and mometasone.

OBJECTIVE: Evidence in vitro suggests that benzalkonium chloride, a preservative in many intranasal preparations, interferes with ciliary function and thus could potentially interfere with mucociliary transport, the mechanism for clearing secretions from the nasal cavity. STUDY DESIGN: We performed a parallel randomized study with 10 subjects in each arm comparing Rhinocort AQUA (an intranasal steroid [budesonide] spray without benzalkonium chloride) and Nasonex (an intranasal steroid [mometasone furoate] spray with benzalkonium chloride). Before and after 2 weeks of treatment, subjects completed a Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and underwent a measurement of nasal clearance of a radioactive colloidal spray into the nose. RESULTS: The groups were matched at entry for nasal clearance, even though there was variability among subjects. The amount of change after 2 weeks of treatment ( Delta before versus after treatment) showed a significant difference in nasal clearance favoring budesonide. After 2 weeks of treatment, both budesonide and mometasone demonstrated overall improvement in quality of life as assessed by the RQLQ. Both treatments were well tolerated. CONCLUSION: Our study extends the observation in vitro that demonstrates the adverse effect of benzalkonium chloride on cilia to a measurement in vivo of clearance. The effects after 2 weeks might not reflect changes after longer periods of treatment. SIGNIFICANCE: To determine the clinical significance of the small improvement in mucociliary transport will require large clinical trials.[1]

References

A comparison of nasal clearance after treatment of perennial allergic rhinitis with budesonide and mometasone. Naclerio, R.M., Baroody, F.M., Bidani, N., De Tineo, M., Penney, B.C. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. (2003) [Pubmed]

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