Table 6.
Summary of results: side effects of systemic corticosteroids.
| Name | Author and publication date | Type of study | Number of patients | Investigated drug | Side effects | Conclusions | Quality of evidence |
|---|---|---|---|---|---|---|---|
| Long-Term Therapy with Corticosteroids in Nasal Polyposis: A Bone Metabolism Assessment [54] | Gelardi 2019 | Case control | 40 | Prednisone. Dose unknown. |
No complications occurred after chronic treatment with OCS(hypertension, type 2 diabetes mellitus, gastric ulcer, cataracts and glaucoma). No increased risk of osteoporosis or osteopenia. | Treatment with corticosteroids did not increase the likelihood of being affected by osteopenia or osteoporosis. | Very low |
| Does the oral steroid treatment of patients with nasal polyposis cause osteopenia or osteoporosis? [55] | Sahlstrand-Johnson 2019 | Case series | 51 | A history of at least two courses of Prednisone equivalents during the last year. Mean intake = 891 mg. |
No high risk of osteoporosis or osteopenia. | 2–3 moderate courses of OCS annually may be used without high risk of causing osteopenia/osteoporosis in patients with CRSwNP. | Very low |
| Cross-reactions to systemic corticosteroids in patients contact sensitized to budesonide [56] | Hansel 2020 | Prospective | 23 | Systemic hydrocortisone 21‐sodium hemisuccinate, methylprednisolone, methylprednisolone sodium succinate, prednisone, triamcinolone. | Allergic reactions. | Patients can have allergic reactions to systemic corticosteroids. | Very low |
| Adrenal suppression and osteoporosis after treatment of nasal polyposis [18] | Bonfils 2006 | Prospective | 46 | Oral corticosteroid consumption during the past year was greater than three short courses of prednisolone 1 mg/kg/day. | Osteoporosis and adrenal insufficiency. | Patients with severe nasal polyposis and a high corticosteroid consumption have a high prevalence of glucocorticoid-induced osteoporosis and secondary adrenal insufficiency. | Low |
| Prevalence of metabolic bone disease among chronic rhinosinusitis patients treated with oral glucocorticoids [57] | Rajasekaran 2010 | Retrospective | 197 | History of oral corticosteroid usage (>5 mg daily for at least 3 months). | Osteoporosis, osteopenia, and low bone density. | Patients with CRS with/without polyposis treated with oral corticosteroids were found to have a high prevalence of low bone density. | Very low |