DrugRescue line

Oral corticosteroids (short course)

Systemic anti-inflammatory

Response rate
Rapid polyp shrinkage
Onset
Days
Route
Oral prednisone 25–50mg, 5–14 day taper
Line
Rescue
IgM effect
Rapid temporary reduction
Evidence level
amber

Evidence summary

Rapid but temporary polyp reduction. EPOS 2020 recommends limiting to 1–2 courses per year due to cumulative toxicity (osteoporosis, diabetes, adrenal suppression, cataracts). Frequent need for oral steroids is an indication for biologic therapy.

Sources (2)

D2Fokkens WJ et al. (2020) European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020)DOI
T5Fokkens WJ et al. (2020) EPOS/EUFOREA 2020 treatment algorithm for CRSwNPDOI