Effects of oral and nasal steroids in nasal polyps: a systematic review
Abstract
OBJECTIVE
To identify the effect of oral and nasal steroids in patients with nasal polyps.
METHODS
We systematically searched through electronic databases including Pubmed, The Cochrane Library, Scopus, Google scholar using keywords related to oral steroids or corticosteroids and nasal polyps. We included studies that used oral plus nasal steroids for treating patients with nasal polyps. The primary outcome was the decrease of nasal polyp size. Other outcomes included hyposmia, nasal obstruction, and nasal nitric oxide. The full texts of the included studies were appraised for risk of bias and their data were extracted for meta-analysis comparing between oral plus nasal steroids and nasal steroids alone or placebo.
RESULTS
Six randomized controlled trials were included in the present review with a total of 490 patients; 335 in oral steroids followed by nasal steroids group, 78 in nasal steroids alone group and 77 in the placebo group. The first comparison is using oral plus nasal steroids compared to nasal steroids alone which the result after 2 weeks of starting oral steroids treatment, oral steroids showed statistically significant decrease nasal polyp size, mean difference (MD) -1.66 (95% confidence interval (CI), -2.54 to -0.78). At the various ends of the studies, oral plus nasal steroids showed statistically significant decrease nasal polyp size, MD -0.43 (95% CI, -0.52 to -0.34). The second comparison is using oral plus nasal steroids compared to placebo which the result after 2 weeks of starting oral steroids treatment, oral steroids showed statistically significant decrease nasal polyp size, MD -0.64 (95% CI, -1.19 to -0.1). After 12 weeks of starting nasal steroids, the patients in treatment group showed the reduction of the nasal polyp size, MD -0.68 (95% CI -1.16 to -0.19).
CONCLUSION
We suggested the possible benefit of oral steroids followed by nasal steroids for decrease nasal polyp size. However, our conclusion was based on 490 patients, the randomized controlled trials with large of participants are suggested.
