Comparison of systemic and local corticosteroids on the clinical and laboratory parameters in patients with perennial allergic rhinitis

Corticosteroids are used for the management of allergic rhinitis. We compared the efficacy of systemic and local corticosteroid in symptom relief and serum IgE levels in patients with perennial allergic rhinitis.

A randomized experimental study design, (clinical trial) was used. 86 patients with a history of perennial allergic rhinitis were selected and randomly divided in two groups. For the first group systemic corticosteroids were given in the form of prednisolone tablet 5mg twice daily, (10mg/day), tapered every 3 days. For the second group, Beclomethasone nasal spray 50 µ g/puff was administered twice daily as two puffs in each nostril for three weeks. Rhinorrhea, nose and eye itching, sneezing, nasal obstruction and serum IgE before and after treatment, (3weeks) were evaluated and compared.

We found a significant decrease in serum IgE in both groups but the decrease was more marked with systemic corticosteroids (P<0.05). After therapy the percentage of sneezing and eye itching decreased significantly in the systemic corticosteroid group and percentage of rhinorrhea decreased significantly in the local corticosteroid group. Pre and post intervention evaluations showed improvement in all symptoms in systemic corticosteroid group and all symptoms except eye itching in local corticosteroid group.

The result of this comparative study showed that systemic corticosteroids are more efficient in improvement of sneezing and eye itching but local corticosteroids may have a better efficacy in the improvement of nasal obstruction.