Hypothalamic‐pituitary‐adrenal axis suppression and intranasal corticosteroid use: A systematic review and meta‐analysis

Background Intranasal corticosteroids (INCS) are used in the management of sinonasal conditions. Use of exogenous steroids can be associated with hypothalamic‐pituitary‐adrenal axis dysfunction and adrenal insufficiency (AI). We aimed to estimate the rate of AI after INCS use in a meta‐analysis, str...

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Bibliographic Details
Published in:International forum of allergy & rhinology 2022-01, Vol.12 (1), p.11-27
Main Authors: Sampieri, Gianluca, Namavarian, Amirpouyan, Lee, John J. W., Hamour, Amr F., Lee, John M.
Format: Article
Language:English
Subjects:
Administration, Intranasal
Adrenal Cortex Hormones - therapeutic use
adrenal insufficiency
adrenal suppression
Adrenocorticotropic hormone
Budesonide
Corticosteroids
Dexamethasone
Fluticasone
Humans
Hypothalamo-Hypophyseal System
Hypothalamus
intranasal steroid
Meta-analysis
Mometasone Furoate
nasal steroid
Patients
Pituitary
Pituitary-Adrenal System
Propionic acid
Steroid hormones
Steroids
Triamcinolone acetonide
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Summary:Background Intranasal corticosteroids (INCS) are used in the management of sinonasal conditions. Use of exogenous steroids can be associated with hypothalamic‐pituitary‐adrenal axis dysfunction and adrenal insufficiency (AI). We aimed to estimate the rate of AI after INCS use in a meta‐analysis, stratified by steroid type and treatment duration. Methods Ovid Medline, Embase Classic, PubMed, Web of Science, and CINAHL databases were searched following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines to identify studies investigating INCS use and AI. AI was defined as morning serum cortisol 
ISSN:2042-6976
2042-6984
DOI:10.1002/alr.22863