Effects of Different Types of Medications on Olfactory Dysfunction in CRSwNP: A Systematic Review and Network Meta‐Analysis

ABSTRACT Objective To evaluate the efficacy of various pharmacological treatments for olfactory disorders in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Data Sources PubMed, Embase, Cochrane Library, and Web of Science. Methods We searched the related literature in PubMed, Embase, Cochrane Library, and Web of Science up to Aug 2024 to appraise the effects of pharmacotherapy on olfactory sensation. After that, two reviewers independently screened the retrieved articles, extracted the pertinent data, and assessed the risk of bias in the included studies. Then we used Stata 14.2 to perform a network meta‐analysis. Results Ninteen randomized controlled trials (RCTs) and 2354 participants were included. Compared with placebo, biologics demonstrated the most significant improvement in subjective olfactory dysfunction (OD) [standardized mean difference (SMD) = −0.75, 95% confidence intervals (CI) (−1.08, −0.41)]. In terms of objective olfactory function improvement, biologics also exhibited the greatest effect (SMD = 0.93, 95% CI [0.56, 1.31]). Among various biologics, dupilumab was the most effective in alleviating both subjective OD (SMD = −1.30, 95% CI [−1.51, −1.09]) and objective OD (mean difference [MD] = 11.13, 95% CI [9.91, 12.35]). Conclusions Our research results indicated that biologics might show better performance in terms of improving the olfactory sensation of patients with CRSwNP, particularly dupilumab. However, given the limitations of this study, future research should employ more standardized olfactory assessment methods and conduct more large‐scale RCTs, ultimately guiding clinicians and patients in making informed and optimal treatment choices. Level of Evidence NA.