Effects of Intranasal Cellulose Powder on Asthma Control in Children With Mild-to-Moderate Perennial Allergic Rhinitis: A Randomized, Placebo-Controlled Trial. Issue 2 (March 2019)

• Record Type: Journal Article
• Authors: Chen, Xi; Guan, Wei-jie; Sun, Shi-xue; Zheng, Pei-yan; Sun, Li-hong; Chen, De-hui; Wang, Dan-dan; Chen, Chang; Sun, Bao-qing; Douglas Zhang, Xiao-hua
• Is Part Of: American journal of rhinology & allergy. Volume 33:Issue 2(2019)
• Page Start: 184
• Page End: 193
• Publication Date: 2019-03
• Subjects: intranasal cellulose powder -- intranasal corticosteroids -- asthma -- perennial allergic rhinitis -- asthma control; Nose -- Periodicals; Allergy -- Periodicals; 616.21005
• DOI: 10.1177/1945892419826509
• Languages: English
• ISSNs: 1945-8924

Abstract

Background: Perennial allergic rhinitis (PAR) often coexists in asthmatic patients. Intranasal cellulose powder (ICP) was reportedly effective in ameliorating PAR. Objective: We investigated whether ICP is equally effective compared with intranasal corticosteroids in improving asthma control as well as nasal symptoms among children with PAR and allergic asthma (AA). Methods: Between July 2015 and September 2016, we did a single-center, randomized, placebo-controlled trial. Asthmatic children aged 6 to 11 years with mild-to-moderate PAR were randomly assigned to formoterol/budesonide inhalation (4·5 µg/80 µg, twice daily) plus intranasal budesonide 64 µg twice daily (group A), ICP 250 µg thrice daily (group B), or intranasal placebo 250 µg thrice daily (group C) for 8 weeks. The primary outcome was change in asthma control test for children (C-ACT) score from baseline to week 8 posttreatment. Changes in spirometry, peak expiratory flow (PEF), fractional exhaled nitric oxide (FeNO), and visual analog scale (VAS) for nasal and ocular symptoms were detected as secondary outcomes. Results: We included 121 patients (38 in group A, 41 in group B, and 42 in group C) in full-analysis set. C-ACT score was markedly higher at week 8 compared with baseline (mean difference: 5.11, 6.05, and 4.85 points in groups A, B, and C, respectively; P < .05). There were interactions between baseline and treatment in C-ACT scores ( P < .05). Group B demonstrated greater improvement in C-ACT score than group C among children with baseline C-ACT score of 6 to 18. 95% confidence intervals of group A at baseline overlapped with those of groups B and C. The treatment achieved reduced VAS symptoms in groups A and B but not in group C. Incidence of adverse events was comparable. No serious adverse event was reported. Conclusions: ICP could be recommended for children with PAR and AA who have poorer asthma control.