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

Authors

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

Published in

European journal of clinical pharmacology. Volume 82. Issue 8. Jul 27, 2026. Epub Jul 27, 2026.

Abstract

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.
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.
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.
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.

PMID:
42507165
Bibliographic data and abstract were imported from PubMed on 27 Jul 2026.

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