Table 4.

Summary of the evidence for ‘efficacy of systemic steroids in CRSsNP in adults’

Study	Year	LOE (1a to 5)	Study design	Study groups	Clinical end-point efficacy	Conclusion
Subramanian et al.	2002	4	Retrospective	CRS patients (23 CRSsNP and 17 CRSwNP) treated with 1 month antibiotics + intranasal steroids + prednisone tapered over 10 days (20 mg 2×/day for 5 days, 20 mg 1×/day for 5 days). Mostly adult patients (2 patients under 18)	Change in CT scores, symptom scores post-treatment. Time to relapse	Beneficial effect of multimodal therapy on scoring of CT, symptoms or both in 90% of all CRS patients, no specific subanalysis for CRSsNP. Beneficial effect continued beyond 8 weeks in 60% of patients. No subanalysis made for CRSsNP
Lal et al.	2009	4	Retrospective	Adult CRS patients (23 CRSsNP and 17 CRSwNP) treated with antibiotics + intranasal steroids + intranasal decongestants + prednisone tapered over 12 days (60, 40, 20, 10 mg for 3 days each)	Complete endoscopic and symptomatic resolution of symptoms 2 months after start of treatment	Beneficial effect of treatment in 54.9% of CRSsNP

CRS chronic rhinosinusitis, CRSsNP chronic rhinosinusitis without nasal polyps, CRSwNP chronic rhinosinusitis with nasal polyps