Effectiveness and safety profile of mepolizumab in chronic rhinosinusitis with nasal polyps: Real life data in a tertiary care

Am J Otolaryngol. 2024 Jul-Aug;45(4):104329. doi: 10.1016/j.amjoto.2024.104329. Epub 2024 Apr 21.

Abstract

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by a type 2 pattern of inflammation. Mepolizumab was approved for the treatment of CRSwNP in 2021, it may be useful to evaluate its safety profile in a real-world setting.

Aim: This work aimed to prospectively highlight the effectiveness and safety profile of Mepolizumab in patients with CRSwNP enrolled in the Otorhinolaryngology Unit of the University Hospital of Messina.

Methods: An observational cohort study was carried out considering all patients treated with Mepolizumab. A descriptive analysis was conducted reporting all demographic characteristics, endoscopic evaluations, and symptom conditions.

Results: A total of 30 patients were treated with Mepolizumab, one patient discontinued the treatment. A statistically significant reduction in the Sino-Nasal Outcome Tests-22 (SNOT-22) and nasal polyp score (NPS) was shown at the 6th and 12th months compared to baseline values (SNOT-22, -33 and - 43, p < 0.001 for both comparisons; NPS, 0 and - 1, p < 0.001 for both comparisons). The median (Q1-Q3) sniffin' sticks test score increased from 7 (6-8) at the 6th month to 11 (10-13) at the 12th month. Seven patients (24.1 %) reported pain at the injection site, accompanied by redness, warmth, and tenderness within the first 24 h post-injection with a median duration of three days from the onset.

Conclusions: Given the optimal treatment response and the minimal adverse effects observed, clinicians should consider Mepolizumab a safe and effective treatment in CRSwNP patients. Further studies in real-life setting are necessary to better understand the long-term effects.

Keywords: Chronic rhinosinusitis with nasal polyps; Mepolizumab; Otorhinolaryngology; Real-word evidence; Safety profile.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal, Humanized* / adverse effects
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Chronic Disease
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasal Polyps* / complications
  • Nasal Polyps* / drug therapy
  • Prospective Studies
  • Rhinitis* / complications
  • Rhinitis* / drug therapy
  • Rhinosinusitis
  • Sino-Nasal Outcome Test
  • Sinusitis* / complications
  • Sinusitis* / drug therapy
  • Tertiary Healthcare
  • Treatment Outcome

Substances

  • mepolizumab
  • Antibodies, Monoclonal, Humanized