The journal of allergy and clinical immunology. Global · 2025
Mepolizumab for the management of chronic rhinosinusitis with nasal polyps across the United States: A retrospective study.
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Cardet Juan Carlos, Silver Jared, Maldonado-Puebla Martin, Laliberté François, Gao Chi, Ramasubramanian Ramya, Hilts Annalise, Zhang Kaixin, Hwee Jeremiah, Ahmed Waseem, Edgecomb Amy G
Аннотация
BACKGROUND: Retrospective data are limited on the effectiveness of mepolizumab treatment that is reflective of real-world practice in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).
OBJECTIVE: We evaluated changes in administration of nasal polyp (NP)-related oral corticosteroids (OCS) and other treatments, exacerbations, sinus surgeries, NP-related health care resource utilization, and costs before and after mepolizumab initiation in patients with CRSwNP.
METHODS: Retrospective cohort study using data from the Komodo Research database included adults with CRSwNP, without severe asthma, initiating mepolizumab therapy on or after July 29, 2021 (index date), with 12 months of continuous health care enrollment before index and ≥6 months after index. Treatment with reslizumab, benralizumab, or tezepelumab during the study period was excluded. Outcomes were compared pre- versus post-mepolizumab initiation for the overall population and on-label subgroup analysis.
RESULTS: Mean number of NP-related OCS dispensings per patient per year (PPPY) (0.5 after vs 1.2 before therapy initiation), total mean OCS dose (119.1 vs 309.9 mg), mean daily OCS dose per period (0.3 vs 0.8 mg), and mean number of OCS bursts (0.3 vs 0.7) were significantly lower after versus before initiation, respectively (all P < .001). Numbers of patients requiring NP-related treatments significantly decreased (75.0% post vs 86.7% pre, P < .001). Mean number of NP-related exacerbations experienced by patients significantly reduced (1.6 PPPY pre vs 0.3 PPPY post). Mean number of sinus surgeries significantly reduced after initiation (annual rate ratio [95% confidence interval] 0.23 [0.13, 0.40], P < .001), as did rate of otolaryngologist visits PPPY, excluding mepolizumab administration visits (rate ratio 0.52 [95% confidence interval 0.43, 0.63], P < .001).
CONCLUSION: In this first retrospective mepolizumab study for patients with CRSwNP without severe asthma, improvements in all outcomes were observed after mepolizumab initiation.
OBJECTIVE: We evaluated changes in administration of nasal polyp (NP)-related oral corticosteroids (OCS) and other treatments, exacerbations, sinus surgeries, NP-related health care resource utilization, and costs before and after mepolizumab initiation in patients with CRSwNP.
METHODS: Retrospective cohort study using data from the Komodo Research database included adults with CRSwNP, without severe asthma, initiating mepolizumab therapy on or after July 29, 2021 (index date), with 12 months of continuous health care enrollment before index and ≥6 months after index. Treatment with reslizumab, benralizumab, or tezepelumab during the study period was excluded. Outcomes were compared pre- versus post-mepolizumab initiation for the overall population and on-label subgroup analysis.
RESULTS: Mean number of NP-related OCS dispensings per patient per year (PPPY) (0.5 after vs 1.2 before therapy initiation), total mean OCS dose (119.1 vs 309.9 mg), mean daily OCS dose per period (0.3 vs 0.8 mg), and mean number of OCS bursts (0.3 vs 0.7) were significantly lower after versus before initiation, respectively (all P < .001). Numbers of patients requiring NP-related treatments significantly decreased (75.0% post vs 86.7% pre, P < .001). Mean number of NP-related exacerbations experienced by patients significantly reduced (1.6 PPPY pre vs 0.3 PPPY post). Mean number of sinus surgeries significantly reduced after initiation (annual rate ratio [95% confidence interval] 0.23 [0.13, 0.40], P < .001), as did rate of otolaryngologist visits PPPY, excluding mepolizumab administration visits (rate ratio 0.52 [95% confidence interval 0.43, 0.63], P < .001).
CONCLUSION: In this first retrospective mepolizumab study for patients with CRSwNP without severe asthma, improvements in all outcomes were observed after mepolizumab initiation.