A randomized comparison of bencycloquidium bromide, mometasone furoate and a combination for persistent allergic rhinitis

Xian Li; Xueyan Wang; Qintai Yang; Jianjun Chen; Hao Tian; Meiping Lu; Tingting Ma; Yana Zhang; Yue Zhou; Jiao Xia; Lei Cheng; Yuan Zhang; Luo Zhang

doi:10.1016/j.jaip.2024.12.035

A randomized comparison of bencycloquidium bromide, mometasone furoate and a combination for persistent allergic rhinitis

J Allergy Clin Immunol Pract. 2024 Dec 31:S2213-2198(24)01284-4. doi: 10.1016/j.jaip.2024.12.035. Online ahead of print.

Authors

Xian Li¹, Xueyan Wang², Qintai Yang³, Jianjun Chen⁴, Hao Tian⁵, Meiping Lu⁶, Tingting Ma², Yana Zhang³, Yue Zhou⁴, Jiao Xia⁵, Lei Cheng⁶, Yuan Zhang⁷, Luo Zhang⁸

Affiliations

¹ Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China.
² Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
³ Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
⁴ Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China.
⁵ Department of Otorhinolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
⁶ Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
⁷ Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China. Electronic address: [email protected].
⁸ Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China. Electronic address: [email protected].

PMID: 39746515
DOI: 10.1016/j.jaip.2024.12.035

Abstract

Background: Moderate to severe persistent allergic rhinitis (AR) poses a substantial socioeconomic burden.

Objectives: We aimed to establish the superiority of bencycloquidium bromide (BCQB) nasal spray and BCQB combined with mometasone furoate nasal spray (MFNS) over MFNS alone in adults with moderate-to-severe persistent AR.

Methods: In this multicentre, randomised controlled clinical trial (NCT05038202), adults with moderate-to-severe persistent AR were randomly assigned to receive the BCQB, MFNS, or a combination treatment, for 4-week periods. The mean changes from baseline in the daily reflective runny nose, nasal congestion, sneezing, nasal itching scores, total nasal symptom score (TNSS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores were recorded. The exploratory endpoints and adverse events were also assessed.

Results: BCQB led to a significant improvement in the mean change from baseline in daily reflective runny nose during the 4-week treatment, in comparison to MFNS (least-squares [LS] mean difference, -0.27; 95% confidence interval [CI], -0.44 to -0.09; P=.004). BCQB combined with MFNS significantly improved runny nose, nasal congestion, sneezing, TNSS, and RQLQ scores compared to MFNS alone, except for nasal itching. BCQB significantly decreased the percentage change in eosinophilic cationic protein, eotaxin, vasoactive intestinal peptide, and interleukin-6 levels. Treatment-emergent adverse events were similar among the three groups.

Conclusion: BCQB was superior to the MFNS in reducing daily runny nose symptoms. The combination of BCQB and MFNS was superior to MFNS alone in alleviating TNSS in patients with moderate-to-severe persistent AR with a predominant symptom of runny nose.

Keywords: allergic rhinitis; cholinergic antagonists; clinical trial; moderate-to-severe.