xRead - Olfactory Disorders (September 2023)

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587

PATEL et al.

TABLE IX.25 Systematic review of topical steroid treatments for OD Author Year LOE Study design Study groups

Clinical end point Studies included only objective psychophysical test confirmation of

Conclusions

Yan, et al. 1517

2019 2

Systematic EBRR Patients with olfactory loss treated with systemic steroids, topical steroids, or both

Topical steroid sprays are NOT effective in treating OD from

nonsinonasal inflammatory

smell loss, eg, UPSIT R and SS-TDI

etiologies, but topical steroid irrigations are effective in treating this patient population significant difference in olfactory thresholds or scored sense of smell among the 3 groups No treatment group had a decrease in olfactory threshold at 2 months No statistically

Blomqvist et al 1521

2003 2

Double-blind RCT Population: 30 URI or idiopathic Severity of smell loss: mixed, details NA Duration of loss: up to 6.6years Treatment: all patients pretreated with 10 days of oral

Follow-up: 6 months CCCRC olfactory test

prednisolone 40 mg twice daily taper + 10 days of fluticasone spray (only improved patients included) fluticasone spray: 2 twice daily (200 μ g everyday) × 6months 10 patients: placebo spray 10 patients: no treatment Population: 13 URI or idiopathic Severity of smell loss: mixed, details NA Duration of loss: 2 to 120 months (median 28 months) Treatment: ceclomethasone spray twice daily × 4weeks Population: 31 URI, posttraumatic, idiopathic Severity of smell loss: 13 of 31 (42%) hyposmic, 18 of 31 (58%) anosmic Duration of loss: 10.5-36 months (median 21 months) 18 patients with OT only 13 patients treated with topical steroid (dose NA) 20 patients: topical

Fleiner

Follow-up: 4 weeks SS-TDI

Median improvement TDI score 2 points 2 of 13 patients (15.4%)

2011 4

Prospective cohort

et al 1519

had clinically relevant change in TDI score (6 points)

Fleiner

2012 4

Retrospective case series

Follow-up: 8 months SS-TDI

Steroid + olfactory

et al 1520

training mean TDI improved 6.83 points ( P < 0.001) vs olfactory training mean TDI improved 2.20 points 5 of 13 patients (38.4%) had clinically significant improvement ( ≥ 6 patients) at 8 months with topical steroids + OT (Continues)