Ann Allergy Asthma Immunol 1999 Aug;83(2):105-11
Milgrom H, Biondi R, Georgitis JW, Meltzer EO, Munk
ZM, Drda K, Wood CC
National Jewish Medical and Research Center and University
of Colorado Health Sciences Center, Denver 80260, USA.
OBJECTIVE: To compare the safety and efficacy of ipratropium bromide 0.03%
(IB) with beclomethasone dipropionate 0.042% (BDP) in the treatment of perennial rhinitis
in children. METHODS: Thirty-three children with nonallergic perennial rhinitis (NAPR)
and 113 with allergic perennial rhinitis (APR) were randomly assigned to either IB or BDP
for 6 months in a single-blind, multicenter protocol in which the physician was blinded to
treatment. At each visit, patients and physicians rated symptom control of rhinorrhea,
nasal congestion, and sneezing. Patients also completed quality of life questionnaires at
baseline and after 6 months of therapy. RESULTS: Both treatments showed a significant improvement in control of
rhinorrhea, congestion, and sneezing compared with baseline over the 6 months of treatment
(P < .05). Only for the control of sneezing was BDP consistently better than IB (P <
.05). Among the patients given IB, 61% to 73% assessed the control of rhinorrhea as good
or excellent on different study visit days, 43% to 60% similarly rated the control of
nasal congestion, and 39% to 43% the control of sneezing. The results for BDP were 68% to
78% for the control of rhinorrhea, 55% to 72% for the control of nasal congestion, and 54%
to 68% for the control of sneezing. Quality of life assessment documented that both drugs
significantly reduced interference with daily activities and disturbance of mood due to
rhinorrhea compared with baseline (P < .05). Both treatments were well tolerated with
IB causing less nasal bleeding and irritation than BDP. CONCLUSIONS:
Ipratropium bromide was safe and effective in controlling rhinorrhea and diminishing the
interference by rhinorrhea in school attendance, concentration on school work, and sleep.
Ipratropium bromide was as effective as BDP in the control of rhinorrhea and showed a
relatively good effect on congestion. Patient and physician assessment favored BDP in the
control of sneezing.
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