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Table 2 Summary of the evidence for ‘efficacy of systemic steroids in AR in adults’

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

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
  1. RCT randomized controlled trial, MP methylprednisolone, AR allergic rhinitis, IM intramuscular