The studies of systemic corticosteroids in this field are relatively few, and meta-analyses are lacking.

Researchers did this study to systematically review the efficacy and safety of systemic corticosteroids for patients with CRSwNP via meta-analysis.

Data were extracted from relevant and appropriate RCTs of systemic corticosteroids for patients with CRSwNP. Efficacy was assessed based on clinical outcomes.

A total of 337 relevant publications were identified, of which 7 RCTs, including 414 participants, were included in the meta-analysis. Compared to placebos or nonsteroid treatments, systemic corticosteroids significantly improved nasal obstruction scores standardized mean difference, reduced the nasal polyp size, and improved PNIF. The high-dose and low-dose subgroups experienced similar benefits. However, insomnia and gastrointestinal disturbances were noted more frequently in patients treated with high doses of prednisone. Other AEs were infrequent and were not significantly different between the subgroups.

The study concluded that systemic corticosteroids provide significant improvements in nasal symptoms and PNIF and a reduction in nasal polyp size for patients with CRSwNP. Prednisone doses less than 50 mg/day were recommended when the efficacy of oral corticosteroids in CRSwNP was balanced against potential adverse effects.