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

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 Wagemann; Job F M van Boven; Philippe Gevaert

doi:10.1186/s13601-019-0303-6

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

Clin Transl Allergy. 2020 Jan 3:10:1. doi: 10.1186/s13601-019-0303-6. eCollection 2020.

Authors

Valerie Hox¹, Evelijn Lourijsen², Arnout Jordens³, Kristian Aasbjerg⁴, Ioana Agache⁵, Isam Alobid^{6

7}, Claus Bachert^{3

8}, Koen Boussery⁹, Paloma Campo¹⁰, Wytske Fokkens², Peter Hellings¹¹, Claire Hopkins¹², Ludger Klimek¹³, Mika Mäkelä¹⁴, Ralph Mösges¹⁵, Joaquim Mullol⁶, Laura Pujols⁶, Carmen Rondon¹⁰, Michael Rudenko¹⁶, Sanna Toppila-Salmi¹⁴, Glenis Scadding¹⁷, Sophie Scheire⁹, Peter-Valentin Tomazic¹⁸, Thibaut Van Zele³, Martin Wagemann¹⁹, Job F M van Boven²⁰, Philippe Gevaert³

Affiliations

¹ 1Cliniques Universitaires Saint-Luc Brussels, Av. Hippocrate 10, 1200 Brussels, Belgium.
² 2Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands.
³ 3Upper Airway Research Laboratory, Dep. of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
⁴ 4Bispebjerg University Hospital, Copenhagen, Denmark.
⁵ Faculty of Medicine, Transsylvania University, Brasov, Romania.
⁶ 6Hospital Clínic, IDIBAPS, CEBERES Universitat de Barcelona, Catalonia, Spain.
⁷ 7Centro Medico Teknon, Barcelona, Spain.
⁸ 8Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden.
⁹ 9Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
¹⁰ 10Allergy Unit, Hospital Regional Universitario of Málaga, IBIMA, ARADyAL, Malaga, Spain.
¹¹ 11Department of Ear, Nose and Throat Disease, University Hospitals, Louvain, Belgium.
¹² 12ENT Department, Guy's & St Thomas' Hospital, London, UK.
¹³ Center of Rhinology and Allergology, Wiesbaden, Germany.
¹⁴ 14Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
¹⁵ 15University of Cologne, Cologne, Germany.
¹⁶ London Allergy and Immunology Center, London, UK.
¹⁷ 17Royal National Throat, Nose and Ear Hospital, London, UK.
¹⁸ 18Medical University Graz, Graz, Austria.
¹⁹ 19Heinrich-Heine-University, Düsseldorf, Germany.
²⁰ 20Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, Groningen, The Netherlands.

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.

Keywords: Glucocorticosteroids; Rhinitis; Rhinosinusitis.

Publication types

Review