BACKGROUND: Off-label high-volume sinonasal budesonide irrigations are commonly used during the management of @entity102 ( @entity102 ). Although short-term use (4 to 8 weeks) has been demonstrated to be safe, the long-term effects on the @entity2339 remain unclear. The objective of this study is to determine whether @entity102 @entity1 using long-term (minimum greater than 12 months) budesonide sinonasal irrigations have evidence of @entity2339 . METHODS: @entity1 with @entity102 being managed with high-volume sinonasal budesonide irrigations were recruited from 2 tertiary level rhinology clinics between March 2014 and July 2015. Inclusion criteria were as follows: (1) adult (age greater than 18 years); (2) guideline-based diagnosis of @entity102 ; (3) previous endoscopic sinus surgery; (4) minimum of twice daily high-volume sinonasal @entity4184 irrigation (concentration of 1 mg per irrigation; total daily dose of 2 mg); and (5) a minimum of 12-month duration. Exclusion criteria included systemic corticosteroid use within 3 months of @entity2339 testing. The primary outcomes were morning (am) serum @entity701 levels and, when indicated, cosyntropin stimulation levels. RESULTS: A total of 35 @entity1 fulfilled eligibility criteria and underwent @entity2339 testing. Mean duration of budesonide sinonasal irrigation therapy use was 38.2 months (2.9  years). The mean    standard deviation (SD) am serum @entity701 was 431.2    146.9 nmol/L (normal, 200 to 650 nmol/L). Subsequent cosyntropin stimulation tests, in indicated @entity1 (n = 19), demonstrated no evidence of @entity2339 . CONCLUSION: Outcomes from this study suggest that daily high-volume sinonasal budesonide irrigations fail to produce evidence of @entity2339 with prolonged courses lasting longer than 2 years.

Safety of long-term high-volume sinonasal budesonide irrigations for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity102 :: ('MESH:D002908', 'Disease') :: ['chronic rhinosinusitis', 'CRS'] @entity2339 :: ('MESH:D007029', 'Disease') :: ['HPA axis', 'hypothalamic-pituitary-adrenal (HPA) axis', 'HPA axis suppression'] @entity701 :: ('MESH:D006854', 'Chemical') :: ['cortisol'] @entity4184 :: ('MESH:D019819', 'Chemical') :: ['budesonide']
@entity102 :: (MESH:D002908,Disease) :: ['chronic rhinosinusitis']
