Budesonide Aqueous Nasal Spray Research Articles

Budenoside aqueous nasal spray: an updated review in managing chronic rhinosinusitis with nasal polyps.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a frequent medical condition. Type 2 inflammation signs CRSwNP in western countries. Type 2 inflammation leads to nasal airflow limitation. Budesonide aqueous nasal spray (BANS) is an intranasal corticosteroid (INCS); it has been launched in the early 1980s. BANS is indicated for treating allergic rhinitis, nonallergic rhinitis, and nasal polyps (both as treatment and prevention after surgery). Consolidated evidence documented its efficacy in treating CRSwNP. In addition, BANS is safe with negligible local and systemic side effects. Recent guidelines for patients with CRSwNP recommend using INCS as the first line in many situations. In particular, patients may assess the perception of symptoms' severity using the Visual Analog Scale (VAS). A score >5/10 means uncontrolled symptoms in both diseases and requires adequate treatment. BANS could appropriately be used in patients with uncontrolled symptoms and/or moderate/severe nasal obstruction. In addition, BANS may adequately integrate surgery and biologics for CRSwNP management. In conclusion, BANS represents a valuable option in managing patients with type 2-mediated CRSwNP.

The updated role of budesonide in managing children and adolescents with allergic rhinitis.

Allergic rhinitis (AR) is a prevalent disease in childhood and adolescence. A type 2 inflammation characterizes AR and, mainly, sustains nasal obstruction. Budesonide aqueous nasal spray (BANS) is an intranasal corticosteroid (INCS) available since the early 1980s. BANS is indicated for treating allergic rhinitis. There is evidence about its efficacy in treating children and adolescents with seasonal and perennial AR. In addition, BANS is safe with negligible local and systemic side effects. Recent guidelines for patients with AR recommend the use of INCS as first line in many situations. In particular, AR patients (and their parents) may assess the perception of symptoms' severity using the Visual Analog Scale (VAS). A score ≥5/10 means uncontrolled symptoms and requires adequate treatment. BANS could appropriately be used in patients with uncontrolled symptoms and/or moderate/severe nasal obstruction. In conclusion, BANS represents a valuable option in managing children and adolescents with AR.

Budenoside aqueous nasal spray: an updated reappraisal in rhinitis management.

Allergic rhinitis (AR) and nonallergic rhinitis are prevalent diseases. In western countries, type 2 inflammation usually characterizes these medical conditions and mainly sustains nasal obstruction. Budesonide aqueous nasal spray (BANS) is an intranasal corticosteroid (INCS) that has been available since the early 1980s. BANS is indicated for treating allergic rhinitis, nonallergic rhinitis, and nasal polyps (both as treatment and prevention after surgery). Consolidated evidence confirms its efficacy in treating seasonal and perennial AR, and nonallergic rhinitis. In addition, BANS is safe with negligible local and systemic side effects. Recent guidelines for patients with AR recommend using INCS as the first line in many situations. In particular, patients may assess the perception of symptoms' severity using the Visual Analog Scale. A score ≥5/10 means uncontrolled symptoms and requires adequate treatment. BANS could appropriately be used in patients with uncontrolled symptoms and/or moderate/severe nasal obstruction. In conclusion, BANS represents a valuable option in managing patients with type 2 inflammation of the nose.

Effects of mobile phone WeChat services improve adherence to corticosteroid nasal spray treatment for chronic rhinosinusitis after functional endoscopic sinus surgery: a 3-month follow-up study.

The objective of the study is to investigate the impact of receiving daily WeChat services on one's cell phone on adherence to corticosteroid nasal spray treatment in chronic rhinosinusitis (CRS) patients after functional endoscopic sinus surgery (FESS). This study was a two-arm, randomized, follow-up investigation. Patients with chronic rhinosinusitis with/without nasal polyps following bilateral FESS were randomised to receive, or to not receive, daily WeChat service on their cell phone to take corticosteroid nasal spray treatment. A prescription of budesonide aqueous nasal spray 128µg bid was given to all the subjects. Then they returned to the clinic after 30, 60, 90days. The primary study outcome was adherence to nasal spray treatment, whereas secondary outcomes were change in endoscopic findings and SinoNasal Outcome Test-20 (SNOT-20). On the whole, there was a significant inter-group difference in the change of adherence rate (F=90.88, p=0.000). The WeChat group had much higher adherence rate than the control group during the follow-up. In terms of postoperative endoscopic scores and SNOT-20, except granulation score, no significant differences were observed between the two randomization groups. WeChat services are already after a short period of observation associated with improved adherence to corticosteroid nasal spray treatment in CRS patients after FESS.

Once-Daily Administration of Intranasal Corticosteroids for Allergic Rhinitis: A Comparative Review of Efficacy, Safety, Patient Preference, and Cost

The aim of this review was to compare the efficacy, safety, patient preference, and cost-effectiveness of once-daily budesonide aqueous nasal spray (BANS), fluticasone propionate nasal spray (FPNS), mometasone furoate nasal spray (MFNS), and triamcinolone aqueous nasal spray (TANS) for treatment of allergic rhinitis (AR) in adult patients. A MEDLINE search (1966 to January 2004) was conducted to identify potentially relevant English language articles. Pertinent abstracts from recent allergy society meetings were identified also. The medical subject heading search terms included were intranasal corticosteroid (INS), nasal steroid, BANS, MFNS, FPNS, or TANS and AR. Selected studies were randomized, controlled, comparison trials of patients with AR treated with once-daily BANS, MFNS, FPNS, or TANS. All four INSs administered once daily were effective and well tolerated in the treatment of AR in adult patients, with similar efficacy and adverse event profiles. No differences were seen between INSs in systemic effects, except for significantly lower overnight urinary cortisol levels in healthy volunteers treated with FPNS compared with placebo. Based on sensory attributes, patients preferred BANS and TANS versus MFNS and FPNS. BANS was associated with more days of treatment per prescription at a lower cost per day for adults compared with the other INSs and is the only INS with a pregnancy category B rating. BANS, FPNS, MFNS, and TANS have similar efficacy and safety profiles. Differences in sensory attributes, documented safety during pregnancy, and cost may contribute to better patient acceptance of one INS versus another and promote better adherence to therapy.

Growth velocity in children with perennial allergic rhinitis treated with budesonide aqueous nasal spray

Recent guidelines recommend intranasal corticosteroids as first-line treatment for managing persistent symptoms of moderate to severe allergic rhinitis (AR). However, in children, long-term continual treatment with corticosteroids has raised concerns about potential growth suppression. To evaluate the effects of the recommended once-daily dose of budesonide aqueous nasal spray on growth velocity, as measured with stadiometry, in children with perennial AR. In this double-blind, placebo-controlled, multicenter study, 229 prepubertal children (mean age, 5.9 years; age range, 4-8 years) with perennial AR were randomized (2:1) to receive budesonide aqueous nasal spray, 64 microg (32 microg per nostril) once daily, or placebo for 1 year. The change from baseline in growth velocity, height after treatment, and the percentage of patients whose percentile for height decreased from baseline to the end of treatment were evaluated. Growth velocity was not significantly different between the 2 groups. The least-squares mean +/- SE growth velocity during treatment was 5.91 +/- 0.11 cm per year for children receiving budesonide and 6.19 +/- 0.16 cm per year for those receiving placebo. The mean difference in growth velocity between the 2 groups was 0.27 +/- 0.18 cm per year (95% confidence interval, -0.07 to 0.62 cm per year). After treatment, the mean +/- SD height was 128.8 +/- 8.7 cm for children receiving budesonide and 128.2 +/- 8.8 for those receiving placebo. The percentage of children whose percentile for height decreased during treatment was not significantly different between the 2 groups (budesonide, 59%, placebo, 54%; P = .64). The incidence and types of adverse events and the mean 24-hour urinary cortisol-creatinine ratio were similar for the 2 groups. Treatment with budesonide aqueous nasal spray, 64 microg once daily, for 1 year did not suppress growth velocity compared with placebo and was well tolerated in prepubertal children with perennial AR.

Allergic Rhinitis in Children: Selecting an Intranasal Corticosteroid

Allergic rhinitis affects up to 40% of children in the United States. Proper management of this disease is important for controlling symptoms, improving quality of life, and preventing the development or exacerbation of comorbid diseases such as asthma, sinusitis, otitis media, and respiratory infections. Intranasal corticosteroids (INSs) are recognized as the most effective medication class for controlling allergic rhinitis symptoms and are recommended by guidelines as first-line treatment for moderate to severe cases of allergic rhinitis in patients of all ages. Four once-daily, aqueous formulations of INSs are available in the United States for pediatric patients: budesonide aqueous nasal spray (BANS), fluticasone propionate nasal spray (FPNS), mometasone furoate nasal spray (MFNS), and triamcinolone acetonide aqueous nasal spray (TANS). The results of comparative studies of these INSs show that all four appear to be similar in efficacy and tolerability. The sensory attributes of these INSs do differ and these differences may play a role in the choice of an INS for each patient. Based on studies in adults, patient preference was found to be greater for the sensory attributes of BANS and TANS than for those of FPNS and MFNS, although a number of patients still showed a preference for the attributes of FPNS and MFNS. Similar studies of INS sensory attributes have not been conducted in children. Prescribing the INS with sensory attributes most pleasing to the individual patient may be important in improving patient acceptance of and satisfaction with treatment and perhaps lead to better adherence with therapy. (Pediatr Asthma Allergy Immunol 2005; 18[4]:216–229.)

Effect of budesonide aqueous nasal spray on hypothalamic-pituitary-adrenal axis function in children with allergic rhinitis

Intranasal corticosteroids are safe and effective for treating allergic rhinitis in adults. Since children may receive more systemic corticosteroid on a dose-per-weight basis than adults, the safety of corticosteroid therapy in pediatric patients is an important issue. To determine the effects of treatment with budesonide aqueous nasal spray using the recommended once-daily dose for adults and children 6 years and older on hypothalamic-pituitary-adrenal (HPA) axis function in pediatric patients with allergic rhinitis. In a 6-week, multicenter, double-blind, placebo-controlled study, 78 patients aged 2 to 5 years with allergic rhinitis were treated with budesonide aqueous nasal spray (64 microg/d) or placebo. Mean change in morning plasma cortisol levels from baseline to study end 0, 30, and 60 minutes after low-dose (10-microg) cosyntropin stimulation and mean change in the difference from 0 to 30 minutes and from 0 to 60 minutes after cosyntropin stimulation were used to evaluate HPA axis function. Mean change from baseline to study end in plasma cortisol levels 0, 30, and 60 minutes after cosyntropin stimulation and the difference from 0 to 30 minutes and from 0 to 60 minutes were not significantly different between the treatment and placebo groups (P > .05 for all). At the end of the study, 3 budesonide aqueous nasal spray and 6 placebo patients were classified as having subnormal HPA axis function. The safety and tolerability profile of budesonide aqueous nasal spray was comparable to that of placebo. Administration of budesonide aqueous nasal spray for 6 weeks was well tolerated and safe and had no measurable suppressive effects on HPA axis function in patients aged 2 to 5 years with allergic rhinitis.

Once-daily budesonide aqueous nasal spray for allergic rhinitis: A review

Background: Allergic rhinitis (AR) is a highly prevalent inflammatory condition with substantial direct and indirect costs. Intranasal corticosteroids are recommended as first-line therapy for moderate to severe persistent AR. Intranasal budesonide is effective and well tolerated; budesonide aqueous nasal spray (BANS) offers several advantages of potential importance to patients, including once-daily dosing at a low volume of spray in a formulation that is free of chlorofluorocarbon propellants, alcohol, benzalkonium chloride, and scents. Objective: This article reviews the findings of randomized, blinded studies assessing the efficacy, safety profile, quality-of-life effects, patient preference, and cost-effectiveness of once-daily BANS in the treatment of AR. Methods: A MEDLINE search (1966-April 2003) was conducted to identify potentially relevant English-language articles. Pertinent abstracts from recent allergy society meetings were also identified. The search strategy employed the medical subject heading terms budesonide, intranasal corticosteroid, or nasal steroid and allergic rhinitis. Selected studies were randomized, controlled clinical trials of once-daily BANS in patients with AR. Results: Based on the results of randomized, double-blind, controlled trials, once-daily BANS is an effective treatment for both seasonal and perennial AR at doses as low as 64 μg (one 32-μg spray per nostril). BANS was well tolerated in these studies, with an adverse-event profile similar to that of placebo, and caused no clinically meaningful suppression of hypothalamic-pituitary-adrenal axis function at doses 4-fold higher than the recommended starting dose. Once-daily administration of BANS 64 μg was similar in efficacy to mometasone furoate nasal spray 200 μg once daily; comparable doses of BANS and fluticasone propionate nasal spray (FPNS) were similar in efficacy as well. Based on specific sensory attributes, patients preferred BANS to FPNS at the recommended once-daily starting doses. BANS was associated with more days of treatment per prescription at a lower cost per day compared with other intranasal corticosteroids. Conclusions: Based on the studies reviewed, BANS administered once daily is an effective and well-tolerated treatment for seasonal and perennial AR in both children and adults. Due to its sensory attributes, efficacy, safety profile, and relatively low cost, BANS may help improve patient adherence.

Measuring the senses: Patients do have like/dislike for various intranasal corticosteroid (INS) product sensory attributes

Rationale Various INSs show similar safety and efficacy for treating allergic rhinitis (AR). Increasingly, prescriber decision-making focuses on the impact that formulation and delivery method have on INS sensory product attributes. We sought to determine the strength of association between detection of INS sensory product attributes and patients' like/dislike for those attributes. Methods We conducted secondary analyses of blinded data from a multicenter, randomized, single-blind (patient), single-dose, 2-period, 1-day crossover study in patients with mild to moderate AR receiving single doses of budesonide aqueous nasal spray (one 32-μg spray/nostril) and fluticasone propionate nasal spray (two 50-μg sprays/nostril) at once-daily recommended starting doses. Sensory attributes evaluated for detection and like/dislike were scent, taste, run down/out throat or nostrils, force/feel of spray in nose or throat, and aftertaste. Authors performed analyses on only the first dose administered and were blind to treatment. Results 181 patient responses were evaluated. The total number of patients detecting sensory attributes assessed varied from N=101 (scent) to N=49 (aftertaste). Sensory attributes significantly associated ( P<0.05) with patients' like/dislike were scent, taste, run out of nostrils, feel in nose and throat, and aftertaste. The strongest association was with taste: 78% of patients who described the taste as very strong or somewhat strong indicated dislike for this sensory attribute, versus only 35% who described taste strength to be weak or neither strong nor weak. Conclusions INS sensory attributes have significant associations with patients' like/dislike for those attributes. Decision-making for AR treatment should involve consideration of patients' preference for certain sensory attributes.

Recommended once-daily dose of budesonide aqueous nasal spray (Rhinocort Aqua®) does not suppress growth velocity in pediatric patients with perennial allergic rhinitis

Rationale Recent guidelines suggest that intranasal corticosteroids should be used as first-line treatment for controlling persistent symptoms of allergic rhinitis (AR), but long-term continual use of corticosteroids can raise growth concerns in a pediatric population. Effects of the recommended once-daily dose of budesonide aqueous nasal spray (BANS; Rhinocort Aqua ®) on growth velocity were examined in pediatric patients with perennial AR. Methods In this 1-year, multicenter, double-blind, placebo-controlled study, 229 pediatric patients (aged 4 to 8 years) with perennial AR were treated with once-daily BANS (64 μg) or placebo. Change in growth velocity and in the percentage of patients whose percentile for height decreased from the 6-month baseline to end of treatment were examined using stadiometry. Results Mean growth velocity (± SE) during the treatment period was 5.91 ± 0.11 cm/year for the BANS group and 6.19 ± 0.16 cm/year for the placebo group. The difference in growth velocity between groups was not significantly different during the 1-year treatment period (0.27 ± 0.18 cm/year; 95% CI, −0.07 to 0.62). The percentage of patients whose percentile for height decreased during the study was also not significantly different between groups (58.5% BANS, 54.1% placebo; p=.64). The incidence and types of adverse events were similar between treatment groups. Five placebo patients and zero BANS patients reported serious adverse events during the treatment period. Conclusion Administration of budesonide aqueous nasal spray 64 μg once daily for 1 year does not suppress growth velocity and is well tolerated in pediatric patients aged 4 to 8 years with perennial AR.

A comparison of rofleponide palmitate nasal spray (RPNS) with budesonide aqueous nasal spray (BANS) and placebo for seasonal allergic rhinitis (AR) using the environmental exposure unit (EEU)

Rationale RPNS, a recently developed nasal glucocorticosteroid for AR, was compared to BANS with known efficacy for AR, and placebo, using the EEU, a controlled-pollen exposure setting. Methods This double-blind, randomized, placebo-controlled, parallel-group study of 291 adults ≥16 years of age with seasonal (ragweed) AR evaluated 3 doses of RPNS (20, 100, 200 μg) with BANS (128 μg) and placebo once daily for 8 days (3 pretreatment days followed by 5 days consisting of 3 hour EEU challenge sessions). Primary efficacy variables were changes in morning and evening total nasal symptom score (TNSS) and peak nasal inspiratory flow (PNIF). Results Only the 200-μg dose of RPNS significantly reduced morning TNSS compared with placebo ( P=.007); no RPNS treatment group demonstrated significant differences in evening TNSS compared with placebo. However, BANS treatment significantly reduced morning TNSS compared with placebo ( P<.001), RPNS 20 μg ( P<.001), and RPNS 100 μg ( P=.009), as well as evening TNSS compared with placebo ( P=.003) and RPNS 20 μg ( P=.001). No RPNS group significantly differed from placebo in either morning or evening PNIF, while BANS significantly increased morning and evening PNIF compared with placebo and RPNS 20 μg ( P<.02 for both). Frequency of AEs was similar between all treatment groups; no serious AEs were reported. Conclusion Rofleponide palmitate nasal spray was less effective than budesonide aqueous nasal spray 128 μg for the relief of symptoms of seasonal AR when compared with placebo and at doses up to 100 μg upon comparing both active medications. Both active medications were well tolerated.

The effect of budesonide on the cytokine pattern in patients with perennial allergic rhinitis

A T(H)2-polarized cytokine pattern has been demonstrated in allergic rhinitis. Budesonide represents an effective topical corticosteroid in the management of allergic rhinitis. To evaluate cytokine pattern and symptoms in patients with perennial allergic rhinitis before and after treatment with intranasal budesonide. All patients received budesonide aqueous nasal spray or placebo for 2 weeks. The study was double-blind, parallel group, placebo controlled, and randomized. Nasal lavage was performed in all patients before and after treatment. A panel of cytokines, including interleukin 4 (IL-4), IL-5, and IL-6, was measured by immunoassay on fluids recovered from nasal lavage. Total symptom score (including rhinorrhea, nasal itching, sneezing, and nasal obstruction) was evaluated before and after treatment. Twenty patients with perennial allergic rhinitis were evaluated (13 men and 7 women; mean age, 24.7 years). Budesonide aqueous nasal spray treatment showed a significant decrease of IL-4 (P = .007), IL-5 (P = .04), and IL-6 levels (P = .009). Budesonide aqueous nasal spray treatment also induced significant symptom relief (P = .006). Placebo treatment did not significantly affect the evaluated parameters. This study shows that budesonide aqueous nasal spray is effective in exerting immunomodulatory activity by reducing cytokine pattern and relieving symptoms. These findings are evidence of the effects of intranasal budesonide in treating perennial allergic rhinitis.

Two multicenter, randomized, single-blind, single-dose, crossover studies of specific sensory attributes of budesonide aqueous nasal spray and fluticasone propionate nasal spray

Background: Intranasal corticosteroids are effective for the treatment of allergic rhinitis. Sensory attributes associated with these sprays may affect patient preference and adherence to treatment regimens. Objectives: These 2 studies compared patients' perceptions of and preferences for specific sensory attributes of budesonide aqueous nasal spray (BANS) and fluticasone propionate nasal spray (FPNS). Methods: In 2 multicenter, randomized, single-blind (patient), single-dose, 2-period, 1-day crossover studies, adults with mild to moderate allergic rhinitis received single doses of BANS (one 32-pg spray per nostril in both studies, 64-μg total dose) and FPNS (two 50-μg sprays per nostril in study 1, 200-pg total dose; one 50-μg spray per nostril in study 2, 100-μg total dose). Study 1 compared the once-daily recommended starting doses of BANS and FPNS, and study 2 compared BANS with half the once-daily recommended dose of FPNS to balance the number of actuations for delivery of study drug. Patients completed the 23-item Sensory Perceptions Questionnaire and indicated their product preference (if any). Results: A total of 110 women and 71 men in study 1 and 136 women and 54 men in study 2 were randomized to treatment. None had previously used BANS or FPNS. In both studies, fewer patients perceived scent or taste (both P < 0.001 in both studies), forceful spray ( P < 0.001 in both studies), and a wet feel in both the nose and throat (study 1, P < 0.004; study 2, P < 0.002) with BANS than with FPNS. In addition, more patients in both studies liked the spray force (study 1, P < 0.01; study 2, P < 0.001) and moisture content in the throat (study 1, P < 0.001; study 2, P < 0.006) of BANS and indicated a greater overall satisfaction with the sensory features of BANS than those of FPNS (study 1, P < 0.001; study 2, P < 0.015). In analyses that included all responding patients, 54.4% of patients in study 1 preferred BANS and 37.8% preferred FPNS ( P < 0.022). In study 2, 47.4% preferred BANS and 41.1% preferred FPNS (not significant). Of the 92.2% of patients in study 1 and 88.4% in study 2 who specified a product preference, 59.0% preferred BANS and 41.0% preferred FPNS in study 1 ( P = 0.021), and 53.6% preferred BANS and 46.4% preferred FPNS in study 2 (not significant). Conclusions: On the basis of perceptions of specific sensory attributes reported after 1 administration in these 2 studies, BANS was rated as more pleasing and preferred over the recommended QD starting dose of FPNS, and was also rated as more pleasing than half the QD recommended starting dose of FPNS.

Budesonide Aqueous Nasal Spray (BANS) is preferred over Fluticasone Propionate Nasal Spray (FPNS) based on specific sensory attributes

Budesonide Aqueous Nasal Spray (BANS) is preferred over Fluticasone Propionate Nasal Spray (FPNS) based on specific sensory attributes

Once-daily budesonide aqueous nasal spray (BANS) does not suppress hypothalamic-pituitary-adrenal (HPA) axis function in children 2 to 5 years of age with allergic rhinitis

Once-daily budesonide aqueous nasal spray (BANS) does not suppress hypothalamic-pituitary-adrenal (HPA) axis function in children 2 to 5 years of age with allergic rhinitis

Healthcare cost analysis of allergic rhinitis treatment: Budesonide aqueous nasal spray versus loratadine

Healthcare cost analysis of allergic rhinitis treatment: Budesonide aqueous nasal spray versus loratadine

Budesonide aqueous nasal spray is an effective treatment in children with perennial allergic rhinitis, with an onset of action within 12 hours

Budesonide aqueous nasal spray is a topical corticosteroid which at doses of 64 to 256 microg once daily has been found to be effective in the treatment of seasonal allergic rhinitis in adults and children. This study was conducted to determine the efficacy of budesonide aqueous nasal spray, 128 microg once daily, in children with perennial allergic rhinitis. This double-blind, randomized, placebo-controlled, parallel-group, multicenter study compared the efficacy and safety of budesonide aqueous nasal spray, 128 microg once daily intranasally, with placebo in 202 patients (aged 6 to 16 years) with perennial allergic rhinitis. Efficacy was evaluated daily by measurement of peak nasal inspiratory flow (PNIF), nasal symptom scores over 12 hours, and an overall evaluation of treatment efficacy. In a subset of patients (n = 76), quality of life was measured by validated questionnaires. Budesonide, 128 microg once daily, was significantly more effective than placebo in improving the PNIF, combined and individual nasal symptom scores, and the overall evaluation of treatment efficacy. The onset of action was found to occur within the first 12-hour time interval evaluated for combined nasal symptoms and within 48 hours for PNIF. Budesonide was associated with reduced percentage of eosinophils in brush samples and reduced intake of rescue medication in comparison with placebo. Quality of life scores were reduced, but the differences did not reach significance. Budesonide aqueous nasal spray, 128 microg once daily, is effective in children with perennial allergic rhinitis. Efficacy was demonstrated within 12 hours.

Budesonide aqueous nasal spray (BANS: Rhinocort® aqua™) is effective as monotherapy in stable patients with chronic rhinosinusitis (CRS)

Budesonide aqueous nasal spray (BANS: Rhinocort® aqua™) is effective as monotherapy in stable patients with chronic rhinosinusitis (CRS)

Sensitivity of a New Grading System for Studying Nasal Polyps with the Potential to Detect Early Changes in Polyp Size after Treatment with a Topical Corticosteroid (Budesonide)

We have previously compared different scoring systems for endoscopic staging of nasal polyps. Of the five methods evaluated, we found that two were better than the others with regard to reproducibility and agreement between physicians. One method was lateral imaging, developed by the authors, and the other was a scoring system developed by Lildholdt et al. The main objective of the present study was to compare the sensitivity of these two methods. Another aim was to study the effect on nasal polyposis of topical nasal corticosteroids over a 2-week period. Patients with bilateral nasal polyposis ( n = 100) were randomized to a 2-week treatment with a topical corticosteroid (budesonide aqueous nasal spray; 128 w g b.i.d.) or placebo in a double-blind manner. Nasal symptoms were scored before treatment and after 3, 7 and 14 days of treatment, and the patients underwent nasal endoscopy at clinical visits. Patients treated with active substance had an improvement in their symptoms, an effect already detectable after 3 days of treatment, compared with those who received placebo. In addition, a statistically significant decrease in polyp size could be registered after 14 days using lateral imaging but not with the other scoring system. In conclusion, lateral imaging was more sensitive and could detect effects earlier than the other scoring system and can be recommended for the endoscopic staging of nasal polyps in clinical studies.