Double‐blind comparison between beclomethasone dipropionate as aerosol and as powder in patients with nasal polyposis

Abstract

Beclomethasone dipropionate as a pressurized aerosol is effective in nasal polyposis, but the efficacy is only moderate. In these partly blocked noses, the insufflated drug used in powder form may be better distributed over the mucous membrane than by the pressurized aerosol. To test this hypothesis, 42 patients with nasal polyposis were treated with intranasal beclomethasone dipropionate as a powder and as a pressurized aerosol in a double-dummy, crossover design. There was no difference between the treatments in 16 patients, while in 12 cases there was a preference for beclomethasone dipropionate as aerosol, and in 14 for the powder form. Fourteen found the aerosol more irritating, 19, the powder. In a group of polyp patients there were no significant differences between the 2 application forms, but possibly there is a need for both aerosol and powder, as there appeared to be differences in the individual responsiveness to the 2 types of intranasal medication. Blind microscopy of wiped nasal-smears before and after beclomethasone dipropionate treatment showed a reduction of basophilic cells, and counting of sneezes after medication demonstrated a reduction in the number of sneezes. Evidently, a reduction of epithelial mediator-cells and of irritant receptor-sensitivity are of importance for the efficacy of topical steroids in rhinitis.