Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper

CC BYSanna Toppila-SalmiSophie ScheireThibaut Van ZeleJob F M van BovenMika J. MäkeläLaura PujolsPeter HellingsKoen BousseryIsam AlobidRalph MösgesPhilippe GevaertMartin WagemannCarmen RondonP. V. TomazicClaire HopkinsIoana AgacheWytske FokkensClaus BachertKristian AasbjergMichael RudenkoArnout JordensValérie HoxJoaquim MullolPaloma CampoLudger KlimekEvelijn LourijsenGlenis Scadding2025-06-192025-06-192020-01-032045-702210.1186/s13601-019-0303-6https://ror.circle-u.eu/handle/123456789/1340906AbstractBecause of the inflammatory mechanisms of most chronic upper airway diseases such as rhinitis and chronic rhinosinusitis, systemic steroids have been used for their treatment for decades. However, it has been very well documented that—potentially severe—side-effects can occur with the accumulation of systemic steroid courses over the years. A consensus document summarizing the benefits of systemic steroids for each upper airway disease type, as well as highlighting the potential harms of this treatment is currently lacking. Therefore, a panel of international experts in the field of Rhinology reviewed the available literature with the aim of providing recommendations for the use of systemic steroids in treating upper airway disease.OPENmedical literatureevidence based medicineMedical Subject HeadingsRhinosinusitisMedical Subject Headingsadverse eventgastrointestinal symptomotorhinolaryngologyeye diseaseReviewnose polypmental diseasesystemic therapyMedical Subject HeadingsDOUBLE-BLINDAdrenal Cortex Hormonescardiovascular diseaseORAL STEROIDSlipid metabolismMedicine and Health SciencesSEVERE NASAL POLYPOSISCushingoid syndromeMedical Subject HeadingsRinitisRhinitisacute rhinosinusitisalternative medicinedrug effectCORTICOSTEROID-THERAPYimmunosuppressive treatmentnose diseaseGlucocorticosteroidsGeneral medicine, internal medicine and other clinical medicinerisk benefit analysisALLERGIC RHINITISpriority journalprotein metabolismSEASONALdiabetes mellitusdrug induced diseaseendocrine diseaseBONE-MINERAL DENSITYENDOSCOPIC SINUS SURGERYpediatric patientSEASONAL ALLERGIC RHINITIShypothalamus hypophysis adrenal systeminjection site discomfortdrug costdesensitizationreviewautoimmune diseasefungal sinusitisPólipos nasalesNasal PolypsWEGENERS-GRANULOMATOSISdrug activityrhinitisshort course therapydrug mechanismHumanscarbohydrate metabolismhumanSinusitisGlucocorticoidesGlucocorticoidsCorticoesteroidesavascular necrosispeptic ulcerMedical Subject Headingsdrug uselong term careallergic rhinitiscalcium balancehypophysis diseasechronic rhinosinusitisMedical Subject Headingsantiinflammatory activityasthmaRC581-607osteoporosisinfectionRHEUMATOID-ARTHRITISdrug efficacyhypothalamus diseaseupper respiratory tract infectionoccupational diseaseglucocorticoidGLUCOCORTICOID-RECEPTOR-ALPHAhyperglycemiaImmunologic diseases. AllergyBenefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paperpublication0302 clinical medicine03 medical and health sciences3. Good healthdoi_dedup___:faf600bc4193d2045db6743484507c52PMC69412823190876310668/36992445/15186311370/f613766b-aab4-4e82-9ce0-674c0fafae652078.1/2271712078.1/26315710138/31334810668/2497420.500.12105/179881854/LU-8650078