Mepolizumab: Which condition benefits more: Nasal polyps or eosinophilic asthma?

Abstract

Introduction: The negative effects of eosinophilic severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) on quality of life are well known. The present study aimed to evaluate the impact of mepolizumab treatment on the quality of life of patients diagnosed with eosinophilic severe asthma and CRSwNP.

Materials and methods: Patients with CRSwNP and eosinophilic severe asthma who had been receiving mepolizumab 100 mg/month for at least six months as treatment were eligible for the study. Patients were assessed using quality of life and disease control questionnaires for both diseases before and during the sixth month of treatment.

Result: Forty-nine patients were included in the present study. Compared to the pre-treatment period, there was significant clinical improvement in quality of life for both rhinitis and asthma following mepolizumab treatment. The changes before and after the treatment were found as follows: Rhinitis Quality of Life Scale [44 (23-72); 25 (6-57); p< 0.001], Nasal Congestion Symptom Assessment Scale [13.0 (8-20); 9.0 (0-20); p< 0.001], Sino-Nasal Outcomes Test-22 (63.16 ± 17.9; 44.16 ± 21.33; p< 0.001), Asthma Quality of Life Questionnaire (111.06 ± 25.17; 142.67 ± 28.04; p< 0.001), Asthma Control Test [16 (6-21); 22 (14-25); p< 0.001]. Before mepolizumab treatment, 20 patients defined that CRSwNP and 29 patients defined that asthma affected their quality of life primarily. After six months of mepolizumab treatment, 38 patients defined that CRSwNP and 11 patients defined that asthma affected their quality of life primarily.

Conclusions: Our results showed that mepolizumab is an effective treatment option for eosinophilic severe asthma and CRSwNP in patients having both diseases. Before mepolizumab, most patients' quality of life was affected by asthma symptoms, but this changed, and their quality of life began to be affected primarily by CRSwNP symptoms. This suggests that mepolizumab treatment is more effective in suppressing asthma symptoms than suppressing nasal polyp symptoms.