{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:30:01Z","timestamp":1789039801511,"version":"build-2803163510"},"reference-count":73,"publisher":"Oceanside Publications Inc.","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Systemic corticosteroids (SCS) are widely used to treat patients with chronic rhinosinusitis with nasal polyps (CRSwNP) that is insufficiently controlled with first-line treatments. However, such treatment must be balanced against the risk of adverse effects with\n protracted or repeated use. Increasing awareness of these adverse effects and the introduction of biologics are changing established management approaches.\n                    <jats:bold>Objective:<\/jats:bold>\n                    The objective was to review the role of SCS in the management of CRSwNP in the evolving treatment landscape.\n                    <jats:bold>Methods:<\/jats:bold>\n                    A literature search was conducted for salient articles on SCS in CRSwNP, including guidelines.\n                    <jats:bold>Results:<\/jats:bold>\n                    SCS reduce inflammation through broad actions on various immune mediators. Short courses of SCS improve symptoms (especially olfactory function)\n and reduce polyp size, benefits that do not persist long-term after treatment ends. SCS are widely used before endoscopic sinus surgery to improve the visibility of the surgical field and after surgery to improve outcomes, although evidence for benefit of postsurgical SCS is lacking. Adverse\n effects associated with SCS can manifest in a wide range of organs and systems. Use of SCS in patients with CRSwNP is associated with an increased risk of avascular necrosis, pneumonia, obesity, anxiety and\/or depression, fracture, sleep apnea, hypothalamic-pituitary-adrenal axis suppression,\n diabetes, and hypertension. The SCS dosage regimen for CRSwNP is not well defined, and there is wide variation in clinical practice. Clinical guidelines refer to \u201cshort courses\u201d of SCS but provide minimal guidance and lack consensus. Biologic treatments for CRSwNP have well-documented\n steroid-sparing effects, but the extent to which biologics might be able to reduce the use of or replace SCS may depend on economics as well as relative benefit-to-risk ratios.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Short courses of SCS are widely used in patients with CRSwNP, but their use must\n be balanced against the risk of adverse effects. Use of biologics may reduce the use of SCS in CRSwNP, minimizing these adverse effects.\n                  <\/jats:p>","DOI":"10.2500\/aap.2025.46.250050","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T04:36:17Z","timestamp":1758083777000},"page":"406-413","source":"Crossref","is-referenced-by-count":12,"title":["The burden of systemic corticosteroids in patients with chronic rhinosinusitis with nasal polyps"],"prefix":"10.2500","volume":"46","author":[{"given":"Anju T.","family":"Peters","sequence":"first","affiliation":[{"name":"From the Allergy-Immunology Division and the Sinus and Allergy Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayant M.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Chicago Medicine and Biological Sciences, Chicago, 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