Examining the safety of prednisolone acetate 1% nasal spray for treatment of nasal polyposis

Jonathan Liang, E Bradley Strong

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Topical intranasal corticosteroid sprays are a mainstay of treatment for nasal polyposis. Newer treatment strategies for refractory polypoid disease include "off label" topical steroids such as prednisolone acetate. This study investigates the safety of intranasal prednisolone acetate; evaluating its effect on serum cortisol and adrenocorticotropin hormone (ACTH) levels. Methods: This retrospective study included adult patients with refractory nasal polyposis, who had not taken oral steroids for 3 months prior to entry into the study. Patients applied 2 sprays of 1% prednisolone acetate delivered via a 15-mL standardized spray bottle twice daily. Morning serum cortisol and ACTH levels were collected prior to treatment and 6 to 8 weeks posttreatment. Pretreatment and posttreatment values were compared. Results: Nine patients were included in this study. The average serum cortisol and ACTH levels prior to treatment was 12.09 μg/dL (95% confidence interval [CI], 6.94-17.24) and 12.33 ng/L (95% CI, 8.97-15.70), respectively. After 6 to 8 weeks of treatment, the average serum cortisol and ACTH levels were 11.76 μg/dL (95%CI, 9.51-14.00) and 13.22 ng/L (95% CI, 10.68-15.77), respectively. There was no statistically significant difference between pretreatment and posttreatment values for cortisol (p = 0.89) or ACTH (p = 0.63). Conclusion: Intranasal delivery of prednisolone acetate, at the specified dose, does not result in suppression of the adrenal axis. It can be considered as a safe alternative for management of aggressive nasal polyposis refractory to traditional treatment strategies.

Original languageEnglish (US)
Pages (from-to)126-129
Number of pages4
JournalInternational Forum of Allergy and Rhinology
Volume2
Issue number2
DOIs
StatePublished - Mar 2012

Fingerprint

Nasal Sprays
Nose
Adrenocorticotropic Hormone
Hydrocortisone
Safety
Hormones
Confidence Intervals
Serum
Therapeutics
Steroids
prednisolone acetate
Adrenal Cortex Hormones
Retrospective Studies

Keywords

  • Cortisol
  • HPA axis
  • Intranasal corticosteroid
  • Nasal polyposis
  • Prednisolone acetate

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Examining the safety of prednisolone acetate 1% nasal spray for treatment of nasal polyposis. / Liang, Jonathan; Strong, E Bradley.

In: International Forum of Allergy and Rhinology, Vol. 2, No. 2, 03.2012, p. 126-129.

Research output: Contribution to journalArticle

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abstract = "Background: Topical intranasal corticosteroid sprays are a mainstay of treatment for nasal polyposis. Newer treatment strategies for refractory polypoid disease include {"}off label{"} topical steroids such as prednisolone acetate. This study investigates the safety of intranasal prednisolone acetate; evaluating its effect on serum cortisol and adrenocorticotropin hormone (ACTH) levels. Methods: This retrospective study included adult patients with refractory nasal polyposis, who had not taken oral steroids for 3 months prior to entry into the study. Patients applied 2 sprays of 1{\%} prednisolone acetate delivered via a 15-mL standardized spray bottle twice daily. Morning serum cortisol and ACTH levels were collected prior to treatment and 6 to 8 weeks posttreatment. Pretreatment and posttreatment values were compared. Results: Nine patients were included in this study. The average serum cortisol and ACTH levels prior to treatment was 12.09 μg/dL (95{\%} confidence interval [CI], 6.94-17.24) and 12.33 ng/L (95{\%} CI, 8.97-15.70), respectively. After 6 to 8 weeks of treatment, the average serum cortisol and ACTH levels were 11.76 μg/dL (95{\%}CI, 9.51-14.00) and 13.22 ng/L (95{\%} CI, 10.68-15.77), respectively. There was no statistically significant difference between pretreatment and posttreatment values for cortisol (p = 0.89) or ACTH (p = 0.63). Conclusion: Intranasal delivery of prednisolone acetate, at the specified dose, does not result in suppression of the adrenal axis. It can be considered as a safe alternative for management of aggressive nasal polyposis refractory to traditional treatment strategies.",
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