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Background <p>The efficacy of glucocorticoids (GCs) for treating non-traumatic olfactory disorders (ODs) remains controversial, with existing meta-analyses showing inconsistent results, largely due to variations in included studies and a lack of etiology-specific analysis.</p> Methods <p>This systematic review and meta-analysis followed a pre-registered protocol (PROSPERO: CRD42022319449). We searched four databases up to December 2025 for studies assessing GCs therapy in adults with non-traumatic ODs. Efficacy was analyzed by etiology, with the primary outcome being the standardized mean difference (SMD) in objective or subjective olfactory score change.</p> Results <p>Thirty-four studies were included. GCs therapy significantly improved olfactory function in patients with COVID-19-related ODs (13 studies, 1538 patients, SMD = 0.53, 95% CI: 0.27–0.79), nasal polyposis (9 studies, 2022 patients, SMD = 0.56, 95% CI: 0.39–0.72), and chronic rhinosinusitis with nasal polyps (5 studies, 318 patients, SMD = 0.89, 95% CI: 0.18–1.59). No significant benefit was found for chronic rhinosinusitis without polyps (4 studies, 464 patients, SMD = 0.25, 95% CI: -0.03-0.53) or allergic rhinitis (3 studies, 240 patients, SMD = 0.50, 95% CI: -0.02-1.01). Significant heterogeneity was observed for the positive outcomes. Given the significant heterogeneity (I² &gt; 50%), subgroup analyses were performed based on the method of olfactory assessment, treatment duration, formulation, and control group type.</p> Conclusion <p>The efficacy of GCs in olfactory dysfunction is probably etiology-dependent. They are most beneficial for ODs related to nasal polyps. For COVID-19-related ODs, short-term intranasal GCs may be effective, while evidence for allergic rhinitis remains inconclusive.</p>

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Effect of glucocorticoids on smell sensation in patients with non-traumatic olfactory disorders: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年7月27日

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  • Sajjad Salimi,
  • Shahin Amiri,
  • Seyed Amir Karimi,
  • Mohammad Mahdi Babajani,
  • Alireza Rezaiemanesh

摘要

Background

The efficacy of glucocorticoids (GCs) for treating non-traumatic olfactory disorders (ODs) remains controversial, with existing meta-analyses showing inconsistent results, largely due to variations in included studies and a lack of etiology-specific analysis.

Methods

This systematic review and meta-analysis followed a pre-registered protocol (PROSPERO: CRD42022319449). We searched four databases up to December 2025 for studies assessing GCs therapy in adults with non-traumatic ODs. Efficacy was analyzed by etiology, with the primary outcome being the standardized mean difference (SMD) in objective or subjective olfactory score change.

Results

Thirty-four studies were included. GCs therapy significantly improved olfactory function in patients with COVID-19-related ODs (13 studies, 1538 patients, SMD = 0.53, 95% CI: 0.27–0.79), nasal polyposis (9 studies, 2022 patients, SMD = 0.56, 95% CI: 0.39–0.72), and chronic rhinosinusitis with nasal polyps (5 studies, 318 patients, SMD = 0.89, 95% CI: 0.18–1.59). No significant benefit was found for chronic rhinosinusitis without polyps (4 studies, 464 patients, SMD = 0.25, 95% CI: -0.03-0.53) or allergic rhinitis (3 studies, 240 patients, SMD = 0.50, 95% CI: -0.02-1.01). Significant heterogeneity was observed for the positive outcomes. Given the significant heterogeneity (I² > 50%), subgroup analyses were performed based on the method of olfactory assessment, treatment duration, formulation, and control group type.

Conclusion

The efficacy of GCs in olfactory dysfunction is probably etiology-dependent. They are most beneficial for ODs related to nasal polyps. For COVID-19-related ODs, short-term intranasal GCs may be effective, while evidence for allergic rhinitis remains inconclusive.