Table 2 Summary of the evidence for ‘efficacy of systemic steroids in AR in adults’
Study | Year | LOE (1a to 5) | Study design | Study groups | Clinical end-point efficacy | Conclusion |
|---|---|---|---|---|---|---|
Borum et al. | 1987 | 1b | RCT | 1. 80 mg MP (n = 12 adults with AR) vs. placebo early in the season (n = 12 adults with AR) 2. 80 mg MP (n = 12) vs. placebo late in the season (n = 12) | 1. Nasal and ocular symptoms 2. Number of sneezings and nose blowing/day | The effect of MP on nasal blockage is marked and last for 4 weeks MP administration before the pollen season is effective but not recommended in clinical practice to avoid too widespread use |
Laursen et al. | 1987 | 1b | RCT | 1. 10 mg betamethasone dipropionate IM single dose and oral placebo (n = 17 adults with AR) × 3 weeks 2. 7.5 mg oral prednisolone × 3 weeks and IM placebo (n = 19 adults with AR) | 1. Nasal and ocular symptoms 2. Blood eosinophils | Both treatments equally controlled hay fever symptoms Reduction of blood eosinophils with both drugs |
Brooks et al. | 1993 | 1b | RCT | 1. Placebo (n = 7 adults with AR) 2. 6 mg MP (n = 8 adults with AR) 3. 12 mg MP (n = 8 adults with AR) 4. 24 mg MP (n = 8 adults with AR) | 1. Nasal and ocular symptoms 2. Dose–response effect 3. Minimal effective dose 4. Relative effectiveness against various symptoms | MP produced dose-related reduction in all symptoms 24 mg MP reduced significantly all symptoms except nasal itching 6 mg MP reduced significantly nasal congestion, drainage, and eye symptoms Not all rhinitis symptoms responded equally to corticoid treatment. Those that responded least could reflect histamine effect, which was not effectively suppressed by low-dose, short-term corticoid treatment |