The NIAMS gratefully acknowledges the assistance of the following individuals in the preparation and review of previous versions of this publication: Gayle Lester, ., Joan McGowan, ., James Panagis, ., Susana Serrate-Sztein, ., and Bernadette Tyree, ., NIAMS/NIH; Kenneth D. Brandt, ., Indiana University School of Medicine, Indianapolis, IN; Victor M. Goldberg, ., University Hospitals of Cleveland, OH; Marc C. Hochberg, ., ., University of Maryland, Baltimore, MD; John Klippel, ., Arthritis Foundation, Atlanta, GA; and Roland Moskowitz, ., Case Western Reserve University, Cleveland, OH. Special thanks also go to the patients who reviewed this publication and provided valuable input.
We identified seven trials, with 895 evaluable participants for this review. All provided data suitable for the primary outcome meta-analysis. One of the trials was new since the last version of this Cochrane systematic review. Risk of bias in the older, smaller studies included some unclear- or high-risk assessments, whereas we deemed the larger studies at low risk of bias. Overall, 79/452 (17%) participants allocated to corticosteroids had incomplete recovery of facial motor function six months or more after randomisation; significantly fewer than the 125/447 (28%) in the control group (risk ratio (RR) , 95% confidence interval (CI) to , seven trials, n = 895). The number of people who need to be treated with corticosteroids to avoid one incomplete recovery was 10 (95% CI 6 to 20). The reduction in the proportion of participants with cosmetically disabling sequelae six months after randomisation was very similar in the corticosteroid and placebo groups (RR , 95% CI to , two trials, n = 75, low-quality evidence). However, there was a significant reduction in motor synkinesis during follow-up in participants receiving corticosteroids (RR , 95% CI to , three trials, n = 485, moderate-quality evidence). Three studies explicitly recorded the absence of adverse effects attributable to corticosteroids. One trial reported that three participants receiving prednisolone had temporary sleep disturbances and two trials gave a detailed account of adverse effects occurring in 93 participants, all non-serious; the combined analysis of data from these three trials found no significant difference in adverse effect rates between people receiving corticosteroids and people receiving placebo (RR , 95% CI to , n = 715).