Mepolizumab in the treatment of severe asthma with nasal polyposis: real-life study

Abstract

Background: Nasal polyposis may impact asthma severity and is a frequent comorbidity in patients with severe eosinophilic asthma. Research has suggested mepolizumab may directly affect upper airway type 2 inflammatory conditions, however there is a lack of clinical studies confirming its effectiveness on nasal symptoms control.

Aims: To assess the impact of mepolizumab on nasal symptoms control in patients with severe eosinophilic asthma and nasal polyposis.

Methods: A multicenter retrospective study was performed in a cohort of patients with both nasal polyposis and severe refractory asthma treated with mepolizumab. Asthma-related parameters and sino-nasal clinical outcomes were analysed in baseline and 6-12 months after treatment initiation.

Results: Twelve patients were included with an average age of 59 years at the start of mepolizumab therapy. The participants were predominantly females (75%) and 58% had history of sinus surgery. After at least 6 months of treatment with mepolizumab, effective control of asthma-related clinical parameters was observed, with a reduction in moderate to severe exacerbations and systemic corticosteroid therapy. In parallel, there was also a statistically significant improvement of sino-nasal symptoms and quality of life, evidenced by a reduction in the average total score on the Sino-Nasal Outcome Test 22, from 70 to 28 points (p= 0.008), and Nasal Congestion scale (range of severe symptoms (3) to mild (1), (p= 0.010)).

Conclusions: Mepolizumab demonstrated clinical efficacy in controlling symptoms associated with nasal polyposis in patients with concomitant severe eosinophilic asthma, giving it the advantage of treating both conditions with the same intervention.