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

Publication date: Jul 27, 2026

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 (I^2 > 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.

Semantics

Original Article