Transforming Patient Experience: Real-World Impact of Mepolizumab on Symptom Burden in Chronic Rhinosinusitis with Nasal Polyps—A Multicenter Perspective

Background: Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) is a type-2 inflammatory upper respiratory disease that has a significant impact on the patient's quality of life. The recommended appropriate medical therapy is effective in controlling CRSwNP symptoms, but some patients are unable to control inflammation. Monoclonal antibodies have recently become a novel and personalized treatment that can help refractory patients restore disease control. Objective: The present study aims to evaluate the effectiveness of mepolizumab in real life settings in a diverse patient population, focusing on assessing the impact of this therapy on patient reported outcomes after six months of treatment. Methods: This is a multicenter, observational study of CRSwNP patients treated with mepolizumab carried out in five hospitals located in Spain. Adult patients with a diagnosis of uncontrolled CRSwNP were included in the study. The change in nasal polyp score (NPS) was the main clinical endpoint. Changes in Sinonasal Outcome Test (SNOT-22), nasal congestion and smell impairment visual analogical scales and blood and nasal polyp tissue eosinophil counts were among other endpoints included. Results: 47 patients were included. 91% were asthmatic. The nasal polyp score (0-8) was reduced significantly in the cohort (mean change: -2.56, p 0.0001). Mean SNOT-22 score improved 25.29 points. Nasal congestion (-3.57, p<0.0001) and smell impairment (-4.0, p<0.0001) visual analogical scales (0 -10) showed a significant improvement. Blood and tissue eosinophil median counts showed a significant reduction versus baseline of 86% and 26% respectively. Among those patients with asthma, the asthma control test score achieved a median value of 24 points. Conclusion: This study provides compelling evidence for the effectiveness of mepolizumab in managing recalcitrant CRSwNP in a real-world setting.