Intranasal budesonide improves quality of life in patient with COPD and chronic nasal symptoms

Background: The coexistence of upper airways disease with chronic obstructive pulmonary disease (COPD) has been scarcely investigated. Recent studies suggest that chronic nasal symptoms (CNS) are frequent in COPD subjects and are associated with dyspnoea and poorer QoL. However, the effect of a specific nasal treatment on COPD symptoms has never been investigated. Methods: Current and ex-smokers with clinically stable COPD and chronic nasal symptoms (nasal discharge, sneezing, nasal congestion, decreased sense of smell and post-nasal drip for more than 8 weeks) were included in the study. COPD patients with skin prick tests positive for at least one of the most prevalent allergens were classified as allergic. All COPD subjects received, in addition to their regular therapy for COPD, intranasal budesonide 400 microg/day, for 8 weeks. At baseline, after 4 and 8 weeks patients underwent to: spirometry, COPD Assessment Test (CAT) in order to evaluate COPD quality of lyfe, and Sino-nasal outcome test-22 (SNOT-22), a validated quality-of-life questionnaire for rhinosinusitis. Results: 55 COPD patients have been enrolled, 25 % COPD patients were allergic. 8 weeks therapy with intranasal budesonide determined a significant reduction of the mean overall CAT score in COPD patients, independently by the allergic condition (p Conclusions: The presence of chronic nasal sympotms should be always evaluated in COPD patients because their treatment significantly improve COPD quality of life.