Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Clinical and Translational Allergy
Published in: Clinical and Translational Allergy 1/2020

Open Access 01-12-2020 | Allergic Rhinitis | Review

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

Authors: Valerie Hox, Evelijn Lourijsen, Arnout Jordens, Kristian Aasbjerg, Ioana Agache, Isam Alobid, Claus Bachert, Koen Boussery, Paloma Campo, Wytske Fokkens, Peter Hellings, Claire Hopkins, Ludger Klimek, Mika Mäkelä, Ralph Mösges, Joaquim Mullol, Laura Pujols, Carmen Rondon, Michael Rudenko, Sanna Toppila-Salmi, Glenis Scadding, Sophie Scheire, Peter-Valentin Tomazic, Thibaut Van Zele, Martin Wagenmann, Job F. M. van Boven, Philippe Gevaert

Published in: Clinical and Translational Allergy | Issue 1/2020

Login to get access

Abstract

Because 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.
Appendix
Available only for authorised users
Literature
1.
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008;63(Suppl 86):8–160.PubMedCrossRef
2.
Morris JB, Shusterman DJ. Toxicology of the nose and upper airways. 1st ed. London: Informa Healthcare; 2010.
3.
van Rijswijk JB, Blom HM, Fokkens WJ. Idiopathic rhinitis, the ongoing quest. Allergy. 2005;60(12):1471–81.PubMedCrossRef
4.
Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012;50(1):1–12.PubMedCrossRef
5.
Tosca MA, Cosentino C, Pallestrini E, Riccio AM, Milanese M, Canonica GW, et al. Medical treatment reverses cytokine pattern in allergic and nonallergic chronic rhinosinusitis in asthmatic children. Pediatr Allergy Immunol. 2003;14(3):238–41.PubMedCrossRef
6.
Hens G, Hellings PW. The nose: gatekeeper and trigger of bronchial disease. Rhinology. 2006;44(3):179–87.PubMed
7.
Mullol J, Alobid I. Combined oral and intranasal corticosteroid therapy: an advance in the management of nasal polyposis? Ann Intern Med. 2011;154(5):365–7.PubMedCrossRef
8.
Santiago T, da Silva JA. Safety of low- to medium-dose glucocorticoid treatment in rheumatoid arthritis: myths and reality over the years. Ann N Y Acad Sci. 2014;1318:41–9.PubMedCrossRef
9.
American Academy of Pediatrics Steering Committee on Quality Improvement and Management. Classifying recommendations for clinical practice guidelines. Pediatrics. 2004;114(3):874–7.CrossRef
10.
11.
Peckett AJ, Wright DC, Riddell MC. The effects of glucocorticoids on adipose tissue lipid metabolism. Metabolism. 2011;60(11):1500–10.PubMedCrossRef
12.
Sapolsky RM, Romero LM, Munck AU. How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions. Endocr Rev. 2000;21(1):55–89.PubMed
13.
14.
Busillo JM, Cidlowski JA. The five Rs of glucocorticoid action during inflammation: ready, reinforce, repress, resolve, and restore. Trends Endocrinol Metab. 2013;24(3):109–19.PubMedPubMedCentralCrossRef
15.
Mullol J, Lopez E, Roca-Ferrer J, Xaubet A, Pujols L, Fernandez-Morata JC, et al. Effects of topical anti-inflammatory drugs on eosinophil survival primed by epithelial cells. Additive effect of glucocorticoids and nedocromil sodium. Clin Exp Allergy. 1997;27(12):1432–41.PubMedCrossRef
16.
Fernandes AM, Valera FC, Anselmo-Lima WT. Mechanism of action of glucocorticoids in nasal polyposis. Braz J Otorhinolaryngol. 2008;74(2):279–83.PubMedCrossRef
17.
Walters EH, Reid DW, Johns DP, Ward C. Nonpharmacological and pharmacological interventions to prevent or reduce airway remodelling. Eur Respir J. 2007;30(3):574–88.PubMedCrossRef
18.
Pujols L, Mullol J, Torrego A, Picado C. Glucocorticoid receptors in human airways. Allergy. 2004;59(10):1042–52.PubMedCrossRef
19.
Beato M, Truss M, Chavez S. Control of transcription by steroid hormones. Ann N Y Acad Sci. 1996;784:93–123.PubMedCrossRef
20.
Pujols L, Mullol J, Roca-Ferrer J, Torrego A, Xaubet A, Cidlowski JA, et al. Expression of glucocorticoid receptor alpha- and beta-isoforms in human cells and tissues. Am J Physiol Cell Physiol. 2002;283(4):C1324–31.PubMedCrossRef
21.
Heitzer MD, Wolf IM, Sanchez ER, Witchel SF, DeFranco DB. Glucocorticoid receptor physiology. Rev Endocr Metab Disord. 2007;8(4):321–30.PubMedCrossRef
22.
Freedman ND, Yamamoto KR. Importin 7 and importin alpha/importin beta are nuclear import receptors for the glucocorticoid receptor. Mol Biol Cell. 2004;15(5):2276–86.PubMedPubMedCentralCrossRef
23.
Pujols L, Mullol J, Picado C. Alpha and beta glucocorticoid receptors: relevance in airway diseases. Curr Allergy Asthma Rep. 2007;7(2):93–9.PubMedCrossRef
24.
Ray A, Prefontaine KE. Physical association and functional antagonism between the p65 subunit of transcription factor NF-kappa B and the glucocorticoid receptor. Proc Natl Acad Sci USA. 1994;91(2):752–6.PubMedPubMedCentralCrossRef
25.
Pelaia G, Vatrella A, Cuda G, Maselli R, Marsico SA. Molecular mechanisms of corticosteroid actions in chronic inflammatory airway diseases. Life Sci. 2003;72(14):1549–61.PubMedCrossRef
26.
Pujols L, Mullol J, Picado C. Importance of glucocorticoid receptors in upper and lower airways. Front Biosci. 2010;15:789–800.CrossRef
27.
Pujols L, Mullol J, Benitez P, Torrego A, Xaubet A, de Haro J, et al. Expression of the glucocorticoid receptor alpha and beta isoforms in human nasal mucosa and polyp epithelial cells. Respir Med. 2003;97(1):90–6.PubMedCrossRef
28.
Pujols L, Mullol J, Perez M, Roca-Ferrer J, Juan M, Xaubet A, et al. Expression of the human glucocorticoid receptor alpha and beta isoforms in human respiratory epithelial cells and their regulation by dexamethasone. Am J Respir Cell Mol Biol. 2001;24(1):49–57.PubMedCrossRef
29.
Pujols L, Alobid I, Benitez P, Martinez-Anton A, Roca-Ferrer J, Fokkens WJ, et al. Regulation of glucocorticoid receptor in nasal polyps by systemic and intranasal glucocorticoids. Allergy. 2008;63(10):1377–86.PubMedCrossRef
30.
Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466–76.PubMedCrossRef
31.
Meltzer EO. The role of nasal corticosteroids in the treatment of rhinitis. Immunol Allergy Clin North Am. 2011;31(3):545–60.PubMedCrossRef
32.
Borum P, Gronborg H, Mygind N. Seasonal allergic rhinitis and depot injection of a corticosteroid. Evaluation of the efficacy of medication early and late in the season based on detailed symptom recording. Allergy. 1987;42(1):26–32.PubMedCrossRef
33.
Brooks CD, Karl KJ, Francom SF. Oral methylprednisolone acetate (medrol tablets) for seasonal rhinitis: examination of dose and symptom response. J Clin Pharmacol. 1993;33(9):816–22.PubMedCrossRef
34.
35.
36.
Bachert C. Persistent rhinitis—allergic or nonallergic? Allergy. 2004;59(Suppl 76):11–5 (discussion 5).PubMedCrossRef
37.
Hellings PW, Klimek L, Cingi C, Agache I, Akdis C, Bachert C, et al. Non-allergic rhinitis: position paper of the European academy of allergy and clinical immunology. Allergy. 2017;72(11):1657–65.PubMedCrossRef
38.
Van Gerven L, Alpizar YA, Wouters MM, Hox V, Hauben E, Jorissen M, et al. Capsaicin treatment reduces nasal hyperreactivity and transient receptor potential cation channel subfamily V, receptor 1 (TRPV1) overexpression in patients with idiopathic rhinitis. J Allergy Clin Immunol. 2014;133(5):1332–9, 1339.e1-3.
39.
Prokopakis E, Nikolaou V, Vardouniotis A, Jorissen M. Nasal manifestations of systemic diseases. B-ent. 2013;9(3):171–84.PubMed
40.
Venekamp RP, Thompson MJ, Hayward G, Heneghan CJ, Del Mar CB, Perera R, et al. Systemic corticosteroids for acute sinusitis. Cochrane Database Syst Rev. 2014;3:CD008115.
41.
Venekamp RP, Bonten MJ, Rovers MM, Verheij TJ, Sachs AP. Systemic corticosteroid monotherapy for clinically diagnosed acute rhinosinusitis: a randomized controlled trial. CMAJ. 2012;184(14):E751–7.PubMedPubMedCentralCrossRef
42.
Gehanno P, Beauvillain C, Bobin S, Chobaut JC, Desaulty A, Dubreuil C, et al. Short therapy with amoxicillin-clavulanate and corticosteroids in acute sinusitis: results of a multicentre study in adults. Scand J Infect Dis. 2000;32(6):679–84.PubMedCrossRef
43.
Klossek JM, Desmonts-Gohler C, Deslandes B, Coriat F, Bordure P, Dubreuil C, et al. Treatment of functional signs of acute maxillary rhinosinusitis in adults. Efficacy and tolerance of administration of oral prednisone for 3 days. Presse Med. 2004;33(5):303–9.PubMedCrossRef
44.
Ratau NP, Snyman JR, Swanepoel C. Short-course, low-dose oral betamethasone as an adjunct in the treatment of acute infective sinusitis: a comparative study with placebo. Clin Drug Investig. 2004;24(10):577–82.PubMedCrossRef
45.
Cannoni M, Sambuc R, San Marco JL, Auquier P, Gorget C, Chiarelli P. Comparative study of the efficacy and tolerance of prednisolone versus niflumic acid in the treatment of acute sinusitis in adults. Ann Otolaryngol Chir Cervicofac. 1990;107(4):276–81.PubMed
46.
Lal D, Hwang PH. Oral corticosteroid therapy in chronic rhinosinusitis without polyposis: a systematic review. Int Forum Allergy Rhinol. 2011;1(2):136–43.PubMedCrossRef
47.
Lal D, Scianna JM, Stankiewicz JA. Efficacy of targeted medical therapy in chronic rhinosinusitis, and predictors of failure. Am J Rhinol Allergy. 2009;23(4):396–400.PubMedCrossRef
48.
Subramanian HN, Schechtman KB, Hamilos DL. A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis. Am J Rhinol. 2002;16(6):303–12.PubMedCrossRef
49.
Bachert C, Wagenmann M, Rudack C, Hopken K, Hillebrandt M, Wang D, et al. The role of cytokines in infectious sinusitis and nasal polyposis. Allergy. 1998;53(1):2–13.PubMedCrossRef
50.
Kakoi H, Hiraide F. A histological study of formation and growth of nasal polyps. Acta Otolaryngol. 1987;103(1–2):137–44.PubMedCrossRef
51.
Hamilos DL, Leung DY, Wood R, Meyers A, Stephens JK, Barkans J, et al. Chronic hyperplastic sinusitis: association of tissue eosinophilia with mRNA expression of granulocyte-macrophage colony-stimulating factor and interleukin-3. J Allergy Clin Immunol. 1993;92(1 Pt 1):39–48.PubMedCrossRef
52.
Stoop AE, van der Heijden HA, Biewenga J, van der Baan S. Eosinophils in nasal polyps and nasal mucosa: an immunohistochemical study. J Allergy Clin Immunol. 1993;91(2):616–22.PubMedCrossRef
53.
Chen YS, Arab SF, Westhofen M, Lorenzen J. Expression of interleukin-5, interleukin-8, and interleukin-10 mRNA in the osteomeatal complex in nasal polyposis. Am J Rhinol. 2005;19(2):117–23.PubMedCrossRef
54.
Olze H, Forster U, Zuberbier T, Morawietz L, Luger EO. Eosinophilic nasal polyps are a rich source of eotaxin, eotaxin-2 and eotaxin-3. Rhinology. 2006;44(2):145–50.PubMed
55.
Head K, Chong LY, Hopkins C, Philpott C, Burton MJ, Schilder AG. Short-course oral steroids alone for chronic rhinosinusitis. Cochrane Database Syst Rev. 2016;4:CD011991.PubMed
56.
Head K, Chong LY, Hopkins C, Philpott C, Schilder AG, Burton MJ. Short-course oral steroids as an adjunct therapy for chronic rhinosinusitis. Cochrane Database Syst Rev. 2016;4:CD011992.PubMed
57.
Alobid I, Benitez P, Cardelus S, de Borja Callejas F, Lehrer-Coriat E, Pujols L, et al. Oral plus nasal corticosteroids improve smell, nasal congestion, and inflammation in sino-nasal polyposis. Laryngoscope. 2014;124(1):50–6.PubMedCrossRef
58.
Alobid I, Benitez P, Pujols L, Maldonado M, Bernal-Sprekelsen M, Morello A, et al. Severe nasal polyposis and its impact on quality of life. The effect of a short course of oral steroids followed by long-term intranasal steroid treatment. Rhinology. 2006;44(1):8–13.PubMed
59.
Ecevit MC, Erdag TK, Dogan E, Sutay S. Effect of steroids for nasal polyposis surgery: a placebo-controlled, randomized, double-blind study. Laryngoscope. 2015;125(9):2041–5.PubMedCrossRef
60.
Hissaria P, Smith W, Wormald PJ, Taylor J, Vadas M, Gillis D, et al. Short course of systemic corticosteroids in sinonasal polyposis: a double-blind, randomized, placebo-controlled trial with evaluation of outcome measures. J Allergy Clin Immunol. 2006;118(1):128–33.PubMedCrossRef
61.
Kapucu B, Cekin E, Erkul BE, Cincik H, Gungor A, Berber U. The effects of systemic, topical, and intralesional steroid treatments on apoptosis level of nasal polyps. Otolaryngol Head Neck Surg. 2012;147(3):563–7.PubMedCrossRef
62.
Kirtsreesakul V, Wongsritrang K, Ruttanaphol S. Clinical efficacy of a short course of systemic steroids in nasal polyposis. Rhinology. 2011;49(5):525–32.PubMedCrossRef
63.
Vaidyanathan S, Barnes M, Williamson P, Hopkinson P, Donnan PT, Lipworth B. Treatment of chronic rhinosinusitis with nasal polyposis with oral steroids followed by topical steroids: a randomized trial. Ann Intern Med. 2011;154(5):293–302.PubMedCrossRef
64.
Van Zele T, Gevaert P, Holtappels G, Beule A, Wormald PJ, Mayr S, et al. Oral steroids and doxycycline: two different approaches to treat nasal polyps. J Allergy Clin Immunol. 2010;125(5):1069.e4–1076.e4.
65.
Bulbul T, Bulbul OG, Guclu O, Bilsel AS, Gursan SO. Effect of glucocorticoids on nasal polyposis, with detection of inflammatory response by measurement of nitric oxide levels in nasal polyp tissue. J Laryngol Otol. 2013;127(6):584–9.PubMedCrossRef
66.
Ozturk F, Bakirtas A, Ileri F, Turktas I. Efficacy and tolerability of systemic methylprednisolone in children and adolescents with chronic rhinosinusitis: a double-blind, placebo-controlled randomized trial. J Allergy Clin Immunol. 2011;128(2):348–52.PubMedCrossRef
67.
Fraire ME, Sanchez-Vallecillo MV, Zernotti ME, Paoletti OA. Effect of premedication with systemic steroids on surgical field bleeding and visibility during nasosinusal endoscopic surgery. Acta Otorrinolaringol Espanola. 2013;64(2):133–9.CrossRef
68.
Wright ED, Agrawal S. Impact of perioperative systemic steroids on surgical outcomes in patients with chronic rhinosinusitis with polyposis: evaluation with the novel perioperative sinus endoscopy (POSE) scoring system. Laryngoscope. 2007;117(11 Pt 2 Suppl 115):1–28.PubMedCrossRef
69.
Sieskiewicz A, Olszewska E, Rogowski M, Grycz E. Preoperative corticosteroid oral therapy and intraoperative bleeding during functional endoscopic sinus surgery in patients with severe nasal polyposis: a preliminary investigation. Ann Otol Rhinol Laryngol. 2006;115(7):490–4.PubMedCrossRef
70.
Gunel C, Basak HS, Bleier BS. Oral steroids and intraoperative bleeding during endoscopic sinus surgery. B-ent. 2015;11(2):123–8.PubMed
71.
Pundir V, Pundir J, Lancaster G, Baer S, Kirkland P, Cornet M, et al. Role of corticosteroids in functional endoscopic sinus surgery—a systematic review and meta-analysis. Rhinology. 2016;54(1):3–19.PubMed
72.
Fokkens WJ, van Drunen C, Georgalas C, Ebbens F. Role of fungi in pathogenesis of chronic rhinosinusitis: the hypothesis rejected. Curr Opin Otolaryngol Head Neck Surg. 2012;20(1):19–23.PubMedCrossRef
73.
Bent JP 3rd, Kuhn FA. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg. 1994;111(5):580–8.PubMedCrossRef
74.
75.
Landsberg R, Segev Y, DeRowe A, Landau T, Khafif A, Fliss DM. Systemic corticosteroids for allergic fungal rhinosinusitis and chronic rhinosinusitis with nasal polyposis: a comparative study. Otolaryngol Head Neck Surg. 2007;136(2):252–7.PubMedCrossRef
76.
Woodworth BA, Joseph K, Kaplan AP, Schlosser RJ. Alterations in eotaxin, monocyte chemoattractant protein-4, interleukin-5, and interleukin-13 after systemic steroid treatment for nasal polyps. Otolaryngol Head Neck Surg. 2004;131(5):585–9.PubMedCrossRef
77.
Kupferberg SB, Bent JP 3rd, Kuhn FA. Prognosis for allergic fungal sinusitis. Otolaryngol Head Neck Surg. 1997;117(1):35–41.PubMedCrossRef
78.
Kuhn FA, Javer AR. Allergic fungal sinusitis: a four-year follow-up. Am J Rhinol. 2000;14(3):149–56.PubMedCrossRef
79.
80.
Fauci AS, Wolff SM. Wegener’s granulomatosis: studies in eighteen patients and a review of the literature. Medicine. 1973;52(6):535–61.PubMedCrossRef
81.
Guillevin L, Cordier JF, Lhote F, Cohen P, Jarrousse B, Royer I, et al. A prospective, multicenter, randomized trial comparing steroids and pulse cyclophosphamide versus steroids and oral cyclophosphamide in the treatment of generalized Wegener’s granulomatosis. Arthritis Rheum. 1997;40(12):2187–98.PubMedCrossRef
82.
Hoffman GS, Leavitt RY, Kerr GS, Fauci AS. The treatment of Wegener’s granulomatosis with glucocorticoids and methotrexate. Arthritis Rheum. 1992;35(11):1322–9.PubMedCrossRef
83.
Wegener’s Granulomatosis Etanercept Trial (WGET) Research Group. Etanercept plus standard therapy for Wegener’s granulomatosis. N Engl J Med. 2005;352(4):351–61.CrossRef
84.
Ribi C, Cohen P, Pagnoux C, Mahr A, Arene JP, Lauque D, et al. Treatment of Churg–Strauss syndrome without poor-prognosis factors: a multicenter, prospective, randomized, open-label study of seventy-two patients. Arthritis Rheum. 2008;58(2):586–94.PubMedCrossRef
85.
Moosig F, Bremer JP, Hellmich B, Holle JU, Holl-Ulrich K, Laudien M, et al. A vasculitis centre based management strategy leads to improved outcome in eosinophilic granulomatosis and polyangiitis (Churg–Strauss, EGPA): monocentric experiences in 150 patients. Ann Rheum Dis. 2013;72(6):1011–7.PubMedCrossRef
86.
87.
Gross WL, Trabandt A, Csernok E. Pathogenesis of Wegener’s granulomatosis. Ann Med Interne. 1998;149(5):280–6.
88.
McAdam LP, O’Hanlan MA, Bluestone R, Pearson CM. Relapsing polychondritis: prospective study of 23 patients and a review of the literature. Medicine. 1976;55(3):193–215.PubMedCrossRef
89.
Aubart FC, Ouayoun M, Brauner M, Attali P, Kambouchner M, Valeyre D, et al. Sinonasal involvement in sarcoidosis: a case-control study of 20 patients. Medicine. 2006;85(6):365–71.PubMedCrossRef
90.
Muangchan C, van Vollenhoven RF, Bernatsky SR, Smith CD, Hudson M, Inanc M, et al. Treatment algorithms in systemic lupus erythematosus. Arthritis Care Res. 2015;67(9):1237–45.CrossRef
91.
Tucci M, Quatraro C, Silvestris F. Sjogren’s syndrome: an autoimmune disorder with otolaryngological involvement. Acta Otorhinolaryngol Ital. 2005;25(3):139–44.PubMedPubMedCentral
92.
Bousquet J. Global initiative for asthma (GINA) and its objectives. Clin Exp Allergy. 2000;30(Suppl 1):2–5.PubMedCrossRef
93.
Pearlman AN, Chandra RK, Chang D, Conley DB, Tripathi-Peters A, Grammer LC, et al. Relationships between severity of chronic rhinosinusitis and nasal polyposis, asthma, and atopy. Am J Rhinol Allergy. 2009;23(2):145–8.PubMedCrossRef
94.
Klossek JM, Neukirch F, Pribil C, Jankowski R, Serrano E, Chanal I, et al. Prevalence of nasal polyposis in France: a cross-sectional, case-control study. Allergy. 2005;60(2):233–7.PubMedCrossRef
95.
Zhang N, Van Zele T, Perez-Novo C, Van Bruaene N, Holtappels G, DeRuyck N, et al. Different types of T-effector cells orchestrate mucosal inflammation in chronic sinus disease. J Allergy Clin Immunol. 2008;122(5):961–8.PubMedCrossRef
96.
Christie R, Scadding J, Boyd J, Brockbank W, Conybeare E, Duthie J. CONTROLLED trial of effects of cortisone acetate in chronic asthma; report to the Medical Research Council by the subcommittee on clinical trials in asthma. Lancet. 1956;271(6947):798–803.
97.
Rowe BH, Spooner CH, Ducharme FM, Bretzlaff JA, Bota GW. Corticosteroids for preventing relapse following acute exacerbations of asthma. Cochrane Database Syst Rev. 2007;3:CD000195.
98.
Hasegawa T, Ishihara K, Takakura S, Fujii H, Nishimura T, Okazaki M, et al. Duration of systemic corticosteroids in the treatment of asthma exacerbation; a randomized study. Intern Med. 2000;39(10):794–7.PubMedCrossRef
99.
Ikeda K, Tanno N, Tamura G, Suzuki H, Oshima T, Shimomura A, et al. Endoscopic sinus surgery improves pulmonary function in patients with asthma associated with chronic sinusitis. Ann Otol Rhinol Laryngol. 1999;108(4):355–9.PubMedCrossRef
100.
Da Silva JA, Jacobs JW, Kirwan JR, Boers M, Saag KG, Ines LB, et al. Safety of low dose glucocorticoid treatment in rheumatoid arthritis: published evidence and prospective trial data. Ann Rheum Dis. 2006;65(3):285–93.PubMedCrossRef
101.
Huscher D, Thiele K, Gromnica-Ihle E, Hein G, Demary W, Dreher R, et al. Dose-related patterns of glucocorticoid-induced side effects. Ann Rheum Dis. 2009;68(7):1119–24.PubMedCrossRef
102.
Martinez-Devesa P, Patiar S. Oral steroids for nasal polyps. Cochrane Database Syst Rev. 2011;7:CD005232.
103.
Mygind N, Laursen LC, Dahl M. Systemic corticosteroid treatment for seasonal allergic rhinitis: a common but poorly documented therapy. Allergy. 2000;55(1):11–5.PubMedCrossRef
104.
Hedner P, Persson G. Suppression of the hypothalamic-pituitary-adrenal axis after a single intramuscular injection of methylprednisolone acetate. Ann Allergy. 1981;47(3):176–9.PubMed
105.
Laursen LC, Faurschou P, Pals H, Svendsen UG, Weeke B. Intramuscular betamethasone dipropionate vs. oral prednisolone in hay fever patients. Allergy. 1987;42(3):168–72.PubMedCrossRef
106.
Bonfils P, Halimi P, Malinvaud D. Adrenal suppression and osteoporosis after treatment of nasal polyposis. Acta Otolaryngol. 2006;126(11):1195–200.PubMedCrossRef
107.
Aasbjerg K, Torp-Pedersen C, Vaag A, Backer V. Treating allergic rhinitis with depot-steroid injections increase risk of osteoporosis and diabetes. Respir Med. 2013;107(12):1852–8.PubMedCrossRef
108.
Rajasekaran K, Seth R, Abelson A, Batra PS. Prevalence of metabolic bone disease among chronic rhinosinusitis patients treated with oral glucocorticoids. Am J Rhinol Allergy. 2010;24(3):215–9.PubMedCrossRef
109.
Winblad L, Larsen CG, Hakansson K, Abrahamsen B, von Buchwald C. The risk of osteoporosis in oral steroid treatment for nasal polyposis: a systematic review. Rhinology. 2017;55(3):195–201.PubMedCrossRef
110.
Matsumoto H, Ishihara K, Hasegawa T, Umeda B, Niimi A, Hino M. Effects of inhaled corticosteroid and short courses of oral corticosteroids on bone mineral density in asthmatic patients: a 4-year longitudinal study. Chest. 2001;120(5):1468–73.PubMedCrossRef
111.
Nasser SM, Ewan PW. Lesson of the week: depot corticosteroid treatment for hay fever causing avascular necrosis of both hips. BMJ. 2001;322(7302):1589–91.PubMedPubMedCentralCrossRef
112.
Kennedy P, Bassiouni A, Psaltis A, Antisdel J, Brunworth J. Avascular necrosis after oral corticosteroids in otolaryngology: case report and review of the literature. Allergy Rhinol. 2016;7(1):50–4.CrossRef
113.
Powell C, Chang C, Naguwa SM, Cheema G, Gershwin ME. Steroid induced osteonecrosis: an analysis of steroid dosing risk. Autoimmun Rev. 2010;9(11):721–43.PubMedPubMedCentralCrossRef
114.
Richards RN. Short-term corticosteroids and avascular necrosis: medical and legal realities. Cutis. 2007;80(4):343–8.PubMed
115.
Hernandez-Diaz S, Rodriguez LA. Steroids and risk of upper gastrointestinal complications. Am J Epidemiol. 2001;153(11):1089–93.PubMedCrossRef
116.
Saag KG, Koehnke R, Caldwell JR, Brasington R, Burmeister LF, Zimmerman B, et al. Low dose long-term corticosteroid therapy in rheumatoid arthritis: an analysis of serious adverse events. Am J Med. 1994;96(2):115–23.PubMedCrossRef
117.
Stuck AE, Minder CE, Frey FJ. Risk of infectious complications in patients taking glucocorticosteroids. Rev Infect Dis. 1989;11(6):954–63.PubMedCrossRef
118.
119.
Poetker DM, Smith TL. Medicolegal implications of common rhinologic medications. Otolaryngol Clin North Am. 2015;48(5):817–26.PubMedCrossRef
120.
Wei L, MacDonald TM, Walker BR. Taking glucocorticoids by prescription is associated with subsequent cardiovascular disease. Ann Intern Med. 2004;141(10):764–70.PubMedCrossRef
121.
Souverein PC, Berard A, Van Staa TP, Cooper C, Egberts AC, Leufkens HG, et al. Use of oral glucocorticoids and risk of cardiovascular and cerebrovascular disease in a population based case-control study. Heart. 2004;90(8):859–65.PubMedPubMedCentralCrossRef
122.
Brown ES, Suppes T, Khan DA, Carmody TJ 3rd. Mood changes during prednisone bursts in outpatients with asthma. J Clin Psychopharmacol. 2002;22(1):55–61.PubMedCrossRef
123.
Naber D, Sand P, Heigl B. Psychopathological and neuropsychological effects of 8-days’ corticosteroid treatment. A prospective study. Psychoneuroendocrinology. 1996;21(1):25–31.PubMedCrossRef
124.
Campieri M, Ferguson A, Doe W, Persson T, Nilsson LG. Oral budesonide is as effective as oral prednisolone in active Crohn’s disease. The Global Budesonide Study Group. Gut. 1997;41(2):209–14.PubMedPubMedCentralCrossRef
125.
Bar-Meir S, Chowers Y, Lavy A, Abramovitch D, Sternberg A, Leichtmann G, et al. Budesonide versus prednisone in the treatment of active Crohn’s disease. The Israeli Budesonide Study Group. Gastroenterology. 1998;115(4):835–40.PubMedCrossRef
126.
127.
Skorpinski EW, Vannelli PM, Yousef E, Brunell T, McGeady SJ. Radiologic outcomes in children with chronic rhinosinusitis and ostiomeatal complex obstruction after medical management. Ann Allergy Asthma Immunol. 2008;100(6):529–32.PubMedCrossRef
128.
Kelly HW, Van Natta ML, Covar RA, Tonascia J, Green RP, Strunk RC, et al. Effect of long-term corticosteroid use on bone mineral density in children: a prospective longitudinal assessment in the childhood Asthma Management Program (CAMP) study. Pediatrics. 2008;122(1):e53–61.PubMedCrossRef
129.
Tse SM, Kelly HW, Litonjua AA, Van Natta ML, Weiss ST, Tantisira KG, et al. Corticosteroid use and bone mineral accretion in children with asthma: effect modification by vitamin D. J Allergy Clin Immunol. 2012;130(1):53.e4–60.e4.CrossRef
130.
Aljebab F, Choonara I, Conroy S. Long-course oral corticosteroid toxicity in children. Arch Dis Child. 2016;101(9):e2.PubMed
131.
Manson SC, Brown RE, Cerulli A, Vidaurre CF. The cumulative burden of oral corticosteroid side effects and the economic implications of steroid use. Respir Med. 2009;103(7):975–94.PubMedCrossRef
132.
Sarnes E, Crofford L, Watson M, Dennis G, Kan H, Bass D. Incidence and US costs of corticosteroid-associated adverse events: a systematic literature review. Clin Ther. 2011;33(10):1413–32.PubMedCrossRef
133.
Barry LE, Sweeney J, O’Neill C, Price D, Heaney LG. The cost of systemic corticosteroid-induced morbidity in severe asthma: a health economic analysis. Respir Res. 2017;18(1):129.PubMedPubMedCentralCrossRef
134.
Luskin AT, Antonova EN, Broder MS, Chang EY, Omachi TA, Ledford DK. Health care resource use and costs associated with possible side effects of high oral corticosteroid use in asthma: a claims-based analysis. Clinicoecon Outcomes Res. 2016;8:641–8.PubMedPubMedCentralCrossRef
135.
Pisu M, James N, Sampsel S, Saag KG. The cost of glucocorticoid-associated adverse events in rheumatoid arthritis. Rheumatology. 2005;44(6):781–8.PubMedCrossRef
136.
Shah M, Chaudhari S, McLaughlin TP, Kan HJ, Bechtel B, Dennis GJ, et al. Cumulative burden of oral corticosteroid adverse effects and the economic implications of corticosteroid use in patients with systemic lupus erythematosus. Clin Ther. 2013;35(4):486–97.PubMedCrossRef
137.
Durham SR, Penagos M. Sublingual or subcutaneous immunotherapy for allergic rhinitis? J Allergy Clin Immunol. 2016;137(2):339.e10–349.e10.CrossRef
138.
Ganderton MA, Brostoff J, Frankland AW. Comparison of preseasonal and coseasonal allpyral with Depo-Medrone in summer hay-fever. BMJ. 1969;1(5640):357–8.PubMedPubMedCentralCrossRef
139.
Aasbjerg K, Torp-Pedersen C, Backer V. Specific immunotherapy can greatly reduce the need for systemic steroids in allergic rhinitis. Allergy. 2012;67(11):1423–9.PubMedCrossRef
140.
Rivero A, Liang J. Anti-IgE and anti-IL5 biologic therapy in the treatment of nasal polyposis: a systematic review and meta-analysis. Ann Otol Rhinol Laryngol. 2017;126(11):739–47.PubMedCrossRef
141.
De Schryver E, Derycke L, Calus L, Holtappels G, Hellings PW, Van Zele T, et al. The effect of systemic treatments on periostin expression reflects their interference with the eosinophilic inflammation in chronic rhinosinusitis with nasal polyps. Rhinology. 2017;55(2):152–60.PubMedCrossRef
142.
Sahota J, Robinson DS. Update on new biologics for intractable eosinophilic asthma: impact of reslizumab. Drug Des Dev Ther. 2018;12:1173–81.CrossRef
Metadata
Title
Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper
Authors
Valerie Hox
Evelijn Lourijsen
Arnout Jordens
Kristian Aasbjerg
Ioana Agache
Isam Alobid
Claus Bachert
Koen Boussery
Paloma Campo
Wytske Fokkens
Peter Hellings
Claire Hopkins
Ludger Klimek
Mika Mäkelä
Ralph Mösges
Joaquim Mullol
Laura Pujols
Carmen Rondon
Michael Rudenko
Sanna Toppila-Salmi
Glenis Scadding
Sophie Scheire
Peter-Valentin Tomazic
Thibaut Van Zele
Martin Wagenmann
Job F. M. van Boven
Philippe Gevaert
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2020
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/s13601-019-0303-6

Other articles of this Issue 1/2020

Clinical and Translational Allergy 1/2020 Go to the issue

Correction

Correction to: Vilnius Declaration on chronic respiratory diseases: multisectoral care pathways embedding guided self-management, mHealth and air pollution in chronic respiratory diseases

Review

Initiating pollen sensitization – complex source, complex mechanisms

Research

Healthy people in healthy premises: the Finnish Indoor Air and Health Programme 2018–2028

Review

Genomics of asthma, allergy and chronic rhinosinusitis: novel concepts and relevance in airway mucosa

Retraction Note

Retraction Note to: Partially hydrolysed, prebiotic supplemented whey formula for the prevention of allergic manifestations in high risk infants: a multicentre double-blind randomised controlled trial

Research

Effectiveness of omalizumab in patients with severe allergic asthma with and without chronic rhinosinusitis with nasal polyps: a PROXIMA study post hoc analysis