A comparison of effects of triamcinolone acetonide aqueous nasal spray, oral prednisone, and placebo on adrenocortical function in male patients with allergic rhinitis.
BACKGROUND
One of the risks associated with the use of oral corticosteroids is suppression of adrenocortical function. Triamcinolone acetonide (TAA) aqueous nasal spray administered once daily (110 micrograms and 220 micrograms) has been shown to reduce allergic rhinitis symptoms.


OBJECTIVE
This multicenter, placebo-controlled, double-blind study determined the effects of TAA aqueous nasal spray, placebo, and oral prednisone on adrenocortical function in patients with allergic rhinitis.


METHODS
Sixty-four patients received TAA aqueous nasal spray (220 micrograms or 440 micrograms), oral prednisone (10 mg), or placebo once daily for 6 weeks. Adrenocortical function was assessed after cosyntropin stimulation for 6 hours before treatment and after 6 weeks of treatment.


RESULTS
There was no statistically significant effect on adrenocortical function in patients who received either dose of TAA aqueous nasal spray compared with placebo. In contrast, prednisone produced statistically significant (p < 0.001) reductions in adrenocortical function compared with placebo; reductions occurred in both the mean 6-hour plasma cortisol levels and mean change in 6-hour plasma cortisol levels from pretreatment.


CONCLUSIONS
This study demonstrated that, unlike oral prednisone, TAA aqueous nasal spray, in therapeutic doses, did not alter adrenocortical function and was comparable to treatment with placebo in its absence of measurable effects on adrenocortical function.
Howland
W C
WC
Healthquest Research, Austin, Texas 78759, USA.
Dockhorn
R
R
Gillman
S
S
Gross
G N
GN
Hille
D
D
Simpson
B
B
Furst
J A
JA
Feiss
G
G
Smith
J A
JA
D000284:Administration, Oral; D000293:Adolescent; D000302:Adrenal Cortex / Q000187:drug effects*; D000304:Adrenal Cortex Function Tests; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*
D014222:Triamcinolone Acetonide; D011241:Prednisone