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. 2024 Jun 18;13(12):3575.
doi: 10.3390/jcm13123575.

Real-Life Evidence of Mepolizumab Treatment in Chronic Rhinosinusitis with Nasal Polyps: A Multicentric Study

Carlo Cavaliere  1 , Antonella Loperfido  2 , Andrea Ciofalo  1 , Loreta Di Michele  3 , Elona Begvarfaj  1 , Gianluca Bellocchi  2 , Marcella Bugani  1 , Marco de Vincentiis  1 , Antonio Greco  1 , Stefano Millarelli  2 , Michaela Plath  4 , Eleonora Sculco  5 , Simonetta Masieri  6
Affiliations

Real-Life Evidence of Mepolizumab Treatment in Chronic Rhinosinusitis with Nasal Polyps: A Multicentric Study

Carlo Cavaliere et al. J Clin Med. .

Abstract

Background: The introduction of biological drugs in the management of chronic rhinosinusitis with nasal polyps (CRSwNP) is allowing new and increasingly promising therapeutic options. This manuscript aims to provide a multicenter trial in a real-life setting on Mepolizumab treatment for severe uncontrolled CRSwNP with or without comorbid asthma. Methods: A retrospective data analysis was jointly conducted at the Otolaryngology-Head and Neck Surgery departments of La Sapienza University and San Camillo Forlanini Hospital in Rome. Both institutions participated by sharing clinical information on patients with CRSwNP treated with Mepolizumab. Patients were evaluated before starting Mepolizumab, at six months and at twelve months from the first drug administration. During follow-up visits, patients underwent endoscopic evaluation, quality of life assessment, nasal symptoms assessment, and blood tests to monitor mainly neutrophils, basophils, eosinophils, and IgG, IgA, and IgE assay. Results: Twenty patients affected by CRSwNP and treated with Mepolizumab were enrolled (12 females and 8 males with a mean age of 63.7 years). Sixteen patients (80%) had concomitant asthma. During follow-up, a gradual improvement in nasal polyp score, quality of life and nasal symptoms, assessed by SNOT-22 and VAS and loss of smell measured by olfactory VAS, was found. Regarding blood tests, eosinophils decreased gradually, while other blood parameters showed no statistically significant changes. Conclusions: Mepolizumab has been shown to be effective in the therapeutic management of patients with CRSwNP. Further studies are needed to support our findings and better understand the underlying immune pathways to predict patients' response to biological treatment in CRSwNP.

Keywords: CRSwNP; IL-5; Mepolizumab; biologics; chronic rhinosinusitis with nasal polyps; mAb; monoclonal antibodies.

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Conflict of interest statement

C.C. has received lecture fees and participated in experts’ board meetings of GSK, Novartis, and Sanofi. A.L., A.C., L.D.M., E.B., G.B., M.B., M.d.V., A.G., S.M. (Stefano Millarelli), M.P., E.S. and S.M. (Simonetta Masieri) declare no conflicts of interest.

Figures

Figure 1
Figure 1
NPS trend. T0: baseline; T1: 6 months of treatment; T2 12 months of treatment.
Figure 2
Figure 2
SNOT-22 trend. T0: baseline; T1: 6 months of treatment; T2 12 months of treatment.
Figure 3
Figure 3
VAS trend. T0: baseline; T1: 6 months of treatment; T2 12 months of treatment.
Figure 4
Figure 4
Olfactory VAS trend. T0: baseline; T1: 6 months of treatment; T2 12 months of treatment.
Figure 5
Figure 5
Absolute eosinophil count trend. T0: baseline; T1: 6 months of treatment; T2 12 months of treatment.
See this image and copyright information in PMC

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