Budesonide reduces nasal congestion symptoms in adults with rhinitis

Treatment with intranasal budesonide significantly reduces nasal congestion symptoms in adults with rhinitis triggered or worsened by airborne pollution, according to a study presented at AAAAI 2022.

A total of 206 patients (aged 20–70 years) with moderate-to-severe rhinitis were included in this post hoc analysis. Of these, 71.8 percent had a baseline nasal congestion score of ≥2 at baseline. Participants were randomized to receive either budesonide nasal spray 256 mcg once daily or placebo (n=74 in each group) for 10 days during high airborne pollution season. Mean change in 24-hour reflective total nasal symptom score (rTNSS) was assessed to determine the sum of severity rating scores for nasal congestion, secretion or runny nose, and itching or sneezing (0=none and 3=severe) over the 10-day treatment period. [AAAAI 2022, abstract L13]

The mean baseline rTNSS were 6.50 and 6.77 in the budesonide and placebo groups, respectively.

Over 10 days, patients who received budesonide had a significantly reduced rTNSS from baseline than those who received placebo (from 6.50 to 3.81 vs from 6.77 to 4.71; p=0.0096), showing an improved rTNSS by 41.4 percent and 30.4 percent, respectively.

The budesonide group also showed a numerically greater reduction from baseline in nasal congestion score over 10 days vs the placebo group (from 2.49 [in both groups] to 1.50 vs 1.65; p=0.0769), indicating improvement in nasal congestion score by 39.8 percent vs 33.7 percent, respectively.

Overall, daily change in rTNSS on days 4 and 10 (p<0.01) was consistently improved with budesonide compared with placebo. There was also a consistent trend towards a greater improvement in a daily change in nasal congestion score (p>0.05), although this was not statistically significant, with budesonide compared with placebo.

More patients on budesonide reported total control over symptoms than those on placebo (9.5 percent vs 2.7 percent), achieving a significantly higher Subject Global Impression of Change score of 2.43 vs 2.15 (p=0.0177).

“While practice guidelines suggest that intranasal corticosteroids (INCS), such as budesonide, are appropriate treatments for rhinitis symptoms with allergic and non-allergic aetiologies, direct clinical study data on the efficacy of INCS in subjects suffering from moderate-to-severe nasal congestion with rhinitis triggered or worsened by airborne pollution are lacking,” said the researchers.

“Budesonide 256 mcg once daily significantly improved total nasal symptoms over 10 days in subjects with rhinitis triggered or worsened by airborne pollution and moderate-to-severe nasal congestion,” said the researchers.

“[Moreover,] patients taking budesonide reported better symptom control vs placebo,” they noted.