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TOPLINE:

In patients with severe, uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP), mepolizumab was associated with substantial improvements in disease-specific quality of life, sinonasal symptoms, endoscopic polyp burden, and asthma control, translating to clinically meaningful gains in health utility.

METHODOLOGY:

• Researchers conducted a prospective real-world cohort study to evaluate the effectiveness of mepolizumab in patients with severe, uncontrolled bilateral CRSwNP.
• They included 96 patients who initiated mepolizumab (mean age, 53.3 years; 54.2% men) across 14 tertiary referral centers in Spain. Mepolizumab was administered subcutaneously at a dose of 100 mg every 4 weeks as add-on therapy to intranasal corticosteroids.
• Clinical assessments were performed at baseline, 6 months, and 12 months.
• Outcomes included disease-specific quality of life, assessed using the 22-item Sinonasal Outcome Test (SNOT-22); sinonasal symptom burden, assessed using visual analog scales (VAS); and endoscopic severity, evaluated using the nasal polyp score (NPS).
• Asthma control was assessed using the Asthma Control Test (ACT).

TAKEAWAY:

• The mean SNOT-22 score improved significantly from 65.2 at baseline to 29.9 at 12 months (P < .001), with 85.4% of patients achieving the minimal clinically important difference of ≥ 12 points.
• The mean scores on the VAS for overall and individual sinonasal symptom burden improved at 12 months (P < .001 for all). The mean NPS decreased significantly from 5.5 at baseline to 2.5 at 12 months (P < .001), with 85.4% of patients achieving a clinically meaningful improvement.
• Asthma control improved significantly, with mean ACT scores increasing by 6.2 points at 12 months (P < .001); 72.9% of patients achieved the minimal clinically important difference of ≥ 3 points. Additionally, health utility values improved by 0.240 at 12 months (P < .001), corresponding to an estimated gain of about 0.14 quality-adjusted life-years.
• The use of systemic corticosteroids decreased significantly compared with that in the previous year. The drug showed a favorable safety profile, with adverse events being infrequent.

IN PRACTICE:

“Taken together, these findings indicate that CRSwNP does not attenuate the response to mepolizumab in patients with asthma. On the contrary, its presence appears to be associated with quantitatively greater improvements in asthma control, underscoring the importance of integrated airway assessment and supporting a global airway approach when evaluating biologic treatment outcomes in routine clinical practice,” the authors of the study wrote.

SOURCE:

Rocío Corrales-Millán, MD, and Juan Maza-Solano, MD, PhD, both with the University Hospital Virgen del Rocío, Seville, Spain, were the corresponding authors of the study, which was published online on June 1, 2026, in European Archives of Oto-Rhino-Laryngology.

LIMITATIONS:

The study did not conduct a formal a priori sample size calculation, so subgroup and interaction analyses may have been underpowered to detect small-to-moderate between-group differences. Objective olfactory function was not assessed with validated smell tests. Moreover, the study lacked a control group.

DISCLOSURES:

The study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Some authors disclosed receiving honoraria for lectures and educational activities, consultancy fees, participation on advisory boards, support for research projects, speaker and presentation fees, expert testimony fees, or travel grants and having other relationships with multiple pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.