Table 7.
Summary of results: other effects of systemic corticosteroids.
| Name | Author and publication date | Type of study | Number of patients | Investigated drug | Side effects | Conclusions | Quality of evidence |
|---|---|---|---|---|---|---|---|
| Increased ILC2s in the eosinophilic nasal polyp endotype are associated with corticosteroid responsiveness [58] | Walford 2014 | Case series | 25 | Prednisone dose greater than 30 mg daily for a minimum of 5 days, or equivalent methylprednisolone daily dose. | Not mentioned. | There were fewer ILC2s in eosinophilic nasal polyps from patients treated with systemic corticosteroid compared with polyps from patients not treated with systemic corticosteroid. | Very low |
| Increased neutrophilia in nasal polyps reduces the response to oral corticosteroid therapy [59] | Wen 2012 | Case series | 266 | 30 mg prednisone once daily for seven days. | Not mentioned. | Patients with the neutrophilic phenotype have less response to treatment with corticosteroids based on symptom scores. | Low |
| Increased serum amyloid A in nasal polyps is associated with systemic corticosteroid insensitivity in patients with chronic rhinosinusitis with nasal polyps: a pilot study [60] | Lu 2018 | Case series | 32 | Oral prednisolone (30 mg daily for 2 weeks). | Not mentioned. | The results indicate that increased serum amyloid A (SAA) in nasal polyposis is associated with reduced response to oral corticosteroids in CRSwNP. | Very low |
| Nasal IL-25 predicts the response to oral corticosteroids in chronic rhinosinusitis with nasal polyps [61] | Hong 2018 | Case series | 52 | 2-weeks oral prednisolone. | Not mentioned. | There were 29 corticosteroid-sensitive patients with CRSwNP where IL-25 increased (tissue level and serum level). | Very low |
| Mucin 1 downregulation associates with corticosteroid resistance in chronic rhinosinusitis with nasal polyps [62] | Milara 2015 | Case series | 73 | Oral deflazacort 1 mg/kg/day for 8 days followed by 0.5 mg/kg/day for 7 days. | Not mentioned. | Mucin 1 expression is associated with corticosteroid efficacy in patients with CRSwNP. | Low |
| MUC4 impairs the anti-inflammatory effects of corticosteroids in patients with chronic rhinosinusitis with nasal polyps [63] | Milara 2017 | Case series | 81 | Oral deflazacort 1 mg/kg/day for 8 days followed by 0.5 mg/kg/day for 7 days. | Not mentioned. | 22 had nasal polyps resistant to OCS. Mucin 4 (MUC4) expression was upregulated in these patients. MUC4 impairs the correct anti-inflammatory effects of corticosteroids. |
Low |
| Short Term Pre-Operative Oral Corticosteroids-Tissue Remodeling in Chronic Rhinosinusitis with Nasal Polyps [64] | Radajewski 2021 | Prospective | 65 | Oral 40 mg prednisolone at least 7 days preoperatively. | Not mentioned. | The number of eosinophil fibrosis decreased in the nasal polyp’s tissue. | Very low |
| Systemic prednisone administration selectively alters granulocyte subsets in nasal polyps from aspirin-exacerbated respiratory disease and chronic rhinosinusitis patients [65] | Edward 2013 | Prospective | 33 | Oral prednisolone 30 mg/day 1 week prior to surgery. | Not mentioned. | Granulocyte subpopulations are focally affected within NPs by systemic corticosteroid exposure. | Low |
| Surfactant protein A and D in chronic rhinosinusitis with nasal polyposis and corticosteroid response [66] | Salman 2012 | Prospective | 36 | 3 weeks oral methylprednisolone 1 mg/kg. |
Not mentioned. | The surfactant protein A and D levels decreased more in patients in the CRSwNP group after methylprednisolone. | Low |
| The effects of systemic, topical, and intralesional steroid treatments on apoptosis level of nasal polyps [67] | Kapucu 2012 | Randomized controlled trial | 48 | Oral methylprednisolone 1 mg/kg/day. | No systemic or local side effects of steroid treatment were seen in any patients. | Systemic glucocorticoids induced apoptosis in nasal polyp tissue when compared with the control group. Systemic corticosteroid treatment induced the most apoptosis. | Low |
| The effects of corticosteroid on tissue lactoferrin in patients with nasal polyposis [68] | Acıoğlu 2012 | Prospective | 41 | 1 mg/kg/day oral methylprednisolone decreasing by 10 mg every 3rd day. | Not mentioned. | Patients with NP have a lower level of tissue lactoferrin (LF). Corticosteroid treatment has no effect on tissue LF concentrations. | Very low |