title: The effect of nasally administered budesonide respules on adrenal cortex function in patients with chronic rhinosinusitis.
abstract: OBJECTIVE
  To evaluate whether nasal administration of budesonide in adults with chronic rhinosinusitis for 30 days suppresses adrenal function and to assess its clinical efficacy.
  
  
  METHODS
  An open-label prospective study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  We assessed adrenal function in 9 patients using the cosyntropin test before and after budesonide therapy.
  
  
  METHODS
  Budesonide respule therapy.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: Division of Clinical Outcomes Research, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri 63110, USA.
authors.forename: Neil S
authors.initials: NS
authors.lastname: Sachanandani
authors.forename: Jay F
authors.initials: JF
authors.lastname: Piccirillo
authors.forename: Maggie A
authors.initials: MA
authors.lastname: Kramper
authors.forename: Stanley E
authors.initials: SE
authors.lastname: Thawley
authors.forename: Anna
authors.initials: A
authors.lastname: Vlahiotis
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000302:Adrenal Cortex / Q000187:drug effects / Q000378:metabolism*; D000328:Adult; D000368:Aged; D019819:Budesonide / Q000008:administration & dosage*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007118:Immunoassay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012220:Rhinitis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D012852:Sinusitis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D019819:Budesonide; D006854:Hydrocortisone