(156) Effect of Intranasal Prednisone Irrigations CRS Patient

Introduction: Topical therapies in chronic rhinosinusitis allow higher concentrations of the pharmacological agent to be distributed in the nasal cavities with fewer systemic effects.
Topical corticosteroids in high doses, provides a greater volume and concentration of these to the nasal-sinus mucosa. Although budesonide improves symptomatology in CRS patients is not largely available in most countries. The objective of this study was to determine whether nasal irrigation using prednisone has an inhibitory effect on the hypothalamic-pituitary-adrenal axis or on intraocular pressure.

Methods: Experimental study. Two groups of patients operated on for chronic rhinosinusitis (either with and without polyps) and that use corticosteroid inhalers were given high-flow nasal irrigation. Group 1 received 2.5 mg/day of prednisone and Group 2 received 5 mg/day. The clinical parameters, endoscopies, the cortisol in urine and intravenous cortisol awakening response levels and IOP were measured before and after the 12 week treatment.

Results: Seven patients in Group 1 and eight patients in Group 2 completed the study. There were no significative changes in the levels of intravenous cortisol awakening response or cortisol in urine levels or IOP. There was a tendency for quality of life to improve according to the SNOT 22 survey and on a symptomatic scale, which had no statistical significance. There were no side effects.

Conclusions:

Conclusion: The use of high-flow nasal irrigation with doses of 2.5 mg and 5 mg of prednisone a day did not decrease cortisol awakening response serum or cortisol in urine levels, nor did it increase IOP in this series, meaning that the number of patients studied could be increased to test for safe use better.