The effects of serum and urinary cortisol levels of topical intranasal irrigations with budesonide added to saline in patients with recurrent polyposis after endoscopic sinus surgery

Kevin C. Welch, Erica R. Thaler, Laurie L. Doghramji, James N. Palmer, Alexander G. Chiu

Research output: Contribution to journalArticle

66 Scopus citations

Abstract

Background: The delivery of topical intranasal corticosteroid sprays has traditionally been the primary method of treating recurrent nasal polyposis. An emerging treatment for polyposis is budesonide nasal irrigations. Delivered at concentrations nearly 100 times greater than found in prescription nasal sprays, there have been little studies on the effects of budesonide irrigation on the adrenal axis. Therefore, we investigated whether irrigation with budesonide solution was associated with any increase in serum cortisol and 24-hour urinary cortisol levels. Methods: Patients who previously had undergone endoscopic sinus surgery and were not taking prednisone for 3 months were prospectively enrolled in this study. Patients irrigated twice daily with 0.5 mg/2 mL of budesonide mixed with 240 mL of saline solution. Serum cortisol and 24-hour urinary cortisol were collected before drug administration and 6 weeks after continuous use. Results: Ten patients completed this study. The average serum cortisol and 24-hour urinary cortisol before drug administration were 9.8 ± 5.4 μg/dL and 28.1 ± 15.1 μg/24 hours, respectively. After 6-week follow-up, the average serum cortisol and 24-hour urinary cortisol were 12.8 ± 3.5 μg/dL and 16.5 ± 5.6 μg/24 hours, respectively. Normal ranges for serum cortisol and 24-hour urinary cortisol are 5-25 μg/dL and 4-50 μg/24 hours, respectively. Conclusions: Irrigation with budesonide, 0.5 mg/2 mL, in 250 mL of saline solution does not result in decreases of serum cortisol and 24-hour urinary cortisol levels. Based on this, we feel irrigation with budesonide solution is safe to perform in patients as an alternative to traditional aerosolized steroid sprays or systemic corticosteroids.

Original languageEnglish (US)
Pages (from-to)26-28
Number of pages3
JournalAmerican Journal of Rhinology and Allergy
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2010
Externally publishedYes

Keywords

  • Adrenal suppression
  • Budesonide
  • Chronic rhinosinusitis
  • Corticosteroids
  • Cortisol
  • Nasal irrigation
  • Nasal polyps
  • Outcomes
  • Safety

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Fingerprint Dive into the research topics of 'The effects of serum and urinary cortisol levels of topical intranasal irrigations with budesonide added to saline in patients with recurrent polyposis after endoscopic sinus surgery'. Together they form a unique fingerprint.

  • Cite this