Local corticosteroids, why are they not used more / properly ?

Area of Science:

• Allergy and immunology
• Otorhinolaryngology
• Pharmacology

Background:

• Nasal corticosteroids have been used for nearly 50 years.
• Systematic reviews over 20 years ago demonstrated their superiority over oral antihistamines for allergic rhinitis.
• Extensive research supports their efficacy in rhinitis and chronic rhinosinusitis (CRS).

Purpose of the Study:

• To highlight the long-standing evidence supporting nasal corticosteroid use.
• To address the persistent gap in clinical adoption despite proven efficacy.
• To advocate for increased utilization of local corticosteroids in managing rhinitis and CRS.

Main Methods:

• Review of historical and contemporary scientific literature.
• Synthesis of evidence from systematic reviews and over 3000 published papers.
• Analysis of treatment outcomes for rhinitis and chronic rhinosinusitis (CRS).

Main Results:

• Nasal corticosteroids demonstrate superior efficacy compared to most other treatments for rhinitis and CRS.
• Decades of research consistently confirm the benefits of local corticosteroid therapy.
• A significant disconnect exists between scientific evidence and clinical practice regarding their use.

Conclusions:

• Nasal corticosteroids are a highly effective treatment for allergic rhinitis and chronic rhinosinusitis (CRS).
• Widespread clinical benefit for patients with these conditions is achievable with local corticosteroid use.
• Further efforts are needed to educate healthcare professionals and the public on the advantages of nasal corticosteroids.