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The effect of nasally administered budesonide respules on adrenal cortex function in patients with chronic
Neil S Sachanandani1, Jay F Piccirillo, Maggie A Kramper
1Division of Clinical Outcomes Research, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri 63110, USA.
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.
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