The effect of nasally administered budesonide respules on adrenal cortex function in patients with chronic rhinosinusitis.

Abstract

OBJECTIVES:

To evaluate whether nasal administration of budesonide in adults with chronic rhinosinusitis for 30 days suppresses adrenal function and to assess its clinical efficacy.

DESIGN:

An open-label prospective study.

SETTING:

Academic medical center.

PATIENTS:

We assessed adrenal function in 9 patients using the cosyntropin test before and after budesonide therapy.

INTERVENTION:

Budesonide respule therapy.

MAIN OUTCOME MEASURE:

Scores from the Sino-Nasal Outcome Test-20 (SNOT-20), a tool for assessing rhinosinusitis health and quality of life, were used to assess efficacy of budesonide treatment.

RESULTS:

All of our patients showed adequate adrenal response to cosyntropin stimulation before and after the budesonide trial. The mean difference in SNOT-20 scores was -1 (95% confidence interval, -1.77 to -0.23; P = .02), indicating clinically significant improvement after therapy.

CONCLUSION:

Our findings suggest that using budesonide nasal wash may be clinically effective in decreasing the symptoms of chronic rhinosinusitis and does so without suppression of the hypothalamic-pituitary-adrenal axis in patients with chronic rhinosinusitis.

• Authors: Neil S Sachanandani, Jay F Piccirillo, Maggie A Kramper, Stanley E Thawley, Anna Vlahiotis
• Journal: Archives of otolaryngology--head & neck surgery (Arch Otolaryngol Head Neck Surg) Vol. 135 Issue 3 Pg. 303-7 (Mar 2009) ISSN: 1538-361X [Electronic] United States
• PMID: 19289711 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Chemical References

• Glucocorticoids
• Budesonide
• Hydrocortisone

Topics

• Administration, Intranasal
• Adolescent
• Adrenal Cortex (drug effects, metabolism)
• Adult
• Aged
• Budesonide (administration & dosage)
• Chronic Disease
• Dose-Response Relationship, Drug
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage)
• Humans
• Hydrocortisone (blood)
• Immunoassay
• Male
• Middle Aged
• Patient Satisfaction
• Prospective Studies
• Rhinitis (blood, complications, drug therapy)
• Sinusitis (blood, complications, drug therapy)
• Surveys and Questionnaires
• Treatment Outcome
• Young Adult