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Steroid Nasal Wash Appears Effective in Patients With Chronic Rhinosinusitis CHICAGO -- March 16, 2009 -- A nasal wash containing budesonide appears to reduce symptoms of chronic rhinosinusitis without suppressing the function of the adrenal glands, according to a study published in the March issue of Archives of Otolaryngology-Head & Neck Surgery. Neil S. Sachanandani, Washington University School of Medicine, St. Louis, Missouri, and colleagues assessed the effects of budesonide on adrenal function in 9 patients between 2005 and 2006. Participants were instructed to use a nasal wash composed of budesonide 0.25 mg and 5 mL of saline in each nostril once daily for 30 days. At clinic visits before and after the treatment period, participants completed a questionnaire assessing their rhinosinusitis symptoms and related quality of life. Their cortisol levels were measured after injection with cosyntropin. All patients showed an adequate adrenal response to cosyntropin before and after budesonide therapy, the authors reported. Total scores on the questionnaire assessing symptoms improved clinically and statistically following therapy. All patients "reported some form of overall improvement with the use of budesonide, and 6 of the 9 patients (67%) would recommend this drug to a friend," the authors wrote. "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." The use of budesonide as a nasal wash has not been approved by the US Food and Drug Administration (FDA), therefore the preparation would be an off-label use, they noted. In addition, clinicians should discuss the risks associated with the use of the product such as decreased bone mineral density. SOURCE: Archives of Otolaryngology-Head & Neck Surgery E-mail this page to a friend or colleague! To print, use this version