慢性鼻窦炎术后大容量生理盐水冲洗后保留在鼻窦腔内的布地奈德定量。

IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY American Journal of Rhinology & Allergy Pub Date : 2024-05-01 Epub Date: 2024-03-08 DOI:10.1177/19458924241237839
Paige A Shipman, Bhuvanesh Yathavan, Amarbir S Gill, Chelsea E Pollard, Venkata Yellepeddi, Hamidreza Ghandehari, Jeremiah A Alt, Abigail Pulsipher, Kristine A Smith
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引用次数: 0

摘要

背景:布地奈德高容量生理盐水冲洗(HVSI)与鼻内皮质类固醇喷雾剂相比,能改善鼻窦给药和疗效,因此被常规用于治疗慢性鼻窦炎(CRS)。一些研究表明,布地奈德 HVSI 的全身吸收剂量较低,因此认为标签外使用布地奈德是安全的。然而,布地奈德HVSI后保留在鼻窦腔内的实际剂量尚不清楚。本研究旨在量化布地奈德在 HVSI 后的保留剂量:方法: 一项前瞻性观察性队列研究将已接受内窥镜鼻窦手术(ESS)并开具布地奈德HVSI处方的CRS成人患者纳入研究。患者在门诊指导下进行布地奈德高压吸引术(0.5 毫克剂量),并收集灌洗流出物。采用高效液相色谱法确定布地奈德HVSI后的保留剂量:结果:24 名患者符合纳入标准。整个队列中布地奈德的平均校正保留剂量为 0.171 ± 0.087 毫克(占布地奈德给药量的 37.9%)。ESS后3个月的患者保留了27.4%的布地奈德剂量(P = .0004):结论:HVSI 后 CRS 患者的布地奈德保留剂量明显高于之前的估计值,并且随着 ESS 后时间的延长而减少。鉴于布地奈德 HVSI 是治疗 CRS 的基石,确定保留剂量和潜在的全身影响对于了解布地奈德 HVSI 的安全性至关重要。
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Quantification of Budesonide Retained in the Sinonasal Cavity After High-Volume Saline Irrigation in Post-Operative Chronic Rhinosinusitis.

Background: Budesonide high-volume saline irrigations (HVSIs) are routinely used to treat chronic rhinosinusitis (CRS) due to improved sinonasal delivery and efficacy compared to intranasal corticosteroid sprays. The off-label use of budesonide is assumed to be safe, with several studies suggesting the systemically absorbed dose of budesonide HVSI is low. However, the actual budesonide dose retained in the sinonasal cavity following HVSI is unknown. The objective of this study was to quantify the retained dose of budesonide after HVSI.

Methods: Adult patients diagnosed with CRS who had undergone endoscopic sinus surgery (ESS) and were prescribed budesonide HVSI were enrolled into a prospective, observational cohort study. Patients performed budesonide HVSI (0.5 mg dose) under supervision in an outpatient clinic, and irrigation effluent was collected. High-performance liquid chromatography was employed to determine the dose of budesonide retained after HVSI.

Results: Twenty-four patients met inclusion criteria. The average corrected retained dose of budesonide across the cohort was 0.171 ± 0.087 mg (37.9% of administered budesonide). Increased time from ESS significantly impacted the measured retained dose, with those 3 months post-ESS retaining 27.4% of administered budesonide (P = .0004).

Conclusion: The retained dose of budesonide in patients with CRS after HVSI was found to be significantly higher than previously estimated and decreased with time post-ESS. Given that budesonide HVSI is a cornerstone of care in CRS, defining the retained dose and the potential systemic implications is critical to understanding the safety of budesonide HVSI.

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来源期刊
CiteScore
5.60
自引率
11.50%
发文量
82
审稿时长
4-8 weeks
期刊介绍: The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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