Table 5.

Summary of results: effect of systemic injected corticosteroids.

Name	Author and publication date	Type of study	Number of patients	Investigated drug	Side effects	Conclusions	Quality of evidence
Expression of genes that encode the annexin-1 and galectin-1 proteins in nasal polyposis and their modulation by glucocorticoid [51]	Fernandes 2010	Prospective	11	A 1 ml ampoule of betamethasone acetate/betamethasone sodium phosphate administered intramuscularly five days before surgery.	Not mentioned.	When subjects were given systemic corticosteroids, the mean gene expression of the anti-inflammatory protein annexin-1 decreased significantly.	Low
Specific immunotherapy can greatly reduce the need for systemic steroids in allergic rhinitis [21]	Aasbjerg 2012	Retrospective	39 173	93.1% received only injected Depo-medrol, Diprospan or Lederspan and 6.9% received subcutaneous immunotherapy and/or corticosteroids.	Not mentioned.	Specific immunotherapy can greatly reduce the need for corticosteroids.	Moderate
Evolution of symptoms associated to nasal polyposis following oral steroid treatment and nasalization of the ethmoid–radical ethmoidectomy is functional surgery for NPS [52]	Jankowski 2003	Case series	24	Prednisolone 60 mg/day for 7 days + the day before surgery and triamcinolone 80 mg depot injection the day after surgery.	No side effects or complications were reported.	Systemic corticosteroids are highly effective to relief symptoms associated to nasal polyposis, but their efficacy disappears over time. 5/6 who poorly responded to OCS had better effect after triamcinolone depot injection and remained stable for 12 months.	Low
Olfaction in patients with nasal polyposis: effects of systemic steroids and radical ethmoidectomy with middle turbinate resection (nasalization) [22]	Jankowski 2003	Case series	56	Prednisolone 60 mg/day for 7 days and depot injection of 80 mg triamcinolone.	No side effects or complications were reported.	Following the 7-day treatment with systemic corticosteroids the olfactory score increased significantly but decreased in the following two months. It re-increased after the depot injection of 80 mg triamcinolone and was stable 12 months after.	Low
Intramuscular betamethasone dipropionate vs. oral prednisolone in hay fever patients [53]	Laursen 1987	Randomized controlled trial	36	Oral prednisolone 7.5 mg/day for 3 weeks or injection with depot betamethasone dipropionate 2 ml.	No severe side effects.	The injection seems to be as effective as the oral treatment, and after 3 weeks treatment with depot steroids, in contrast to oral treatment, there seems to be no suppression of the hypothalamic pituitary-adrenal axis.	Low