Budesonide Nasal Wash Not Linked to Adrenal Suppression

After month, adults showed sinus improvements without suppression of adrenal function

WEDNESDAY, March 18 (HealthDay News) -- The use of budesonide as a nasal wash in adults with chronic rhinosinusitis appears to relieve symptoms without suppressing the hypothalamic-pituitary-adrenal axis, according to research published in the March issue of the Archives of Otolaryngology - Head & Neck Surgery.

Neil S. Sachanandani, of the Washington University School of Medicine in St. Louis, and colleagues analyzed data from nine adults with chronic rhinosinusitis who used budesonide respules for nasal washing daily for 30 days. Subjects completed the Sino-Nasal Outcome Test-20 (SNOT-20) and underwent a cosyntropin test of adrenal function before and after the intervention.

Improvements on the SNOT-20 score suggested a clinically meaningful improvement in rhinosinusitis health status and quality of life, the researchers report. All patients showed sufficient adrenal response to cosyntropin stimulation at both points, suggesting that the budesonide did not significantly suppress adrenal function, the authors note.

"The clinical significance of this study is that budesonide nasal respules appear safe for short-term use for the relief of symptoms associated with chronic sinusitis. Budesonide respules seem to provide an effective treatment option for the patient with chronic rhinosinusitis with minimal fear of systemic adverse effects. It should be noted that the use of budesonide as a nasal lavage constitutes 'off-label' use. The Food and Drug Administration has not approved the use of budesonide for nasal lavage," Sachanandani and colleagues write.

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