Acta otorrinolaringologica espanola · 2026
Evaluating mepolizumab and dupilumab for severe chronic rhinosinusitis with nasal polyps: insights from a real-life study.
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Gálvez-Gafo Laura, Mariño-Sánchez Franklin, Yeguas-Ramírez Laura, Muñoz-García María, Sánchez-Cuéllar Silvia, Antolín-Amérigo Darío, González-De-Olano David, Santamaría-Gadea Alfonso
Аннотация
INTRODUCTION: Monoclonal antibodies (mAbs) have been effective in managing chronic rhinosinusitis with nasal polyps (CRSwNP) for over two decades, primarily as secondary treatments for severe asthma or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD). Recent approvals of biologics like mepolizumab (anti-IL5) and dupilumab (anti-IL4/IL13) now allow their use as add-on therapies for severe CRSwNP, regardless of comorbidities. However, limited data exist on their efficacy as standalone primary treatments for CRSwNP. This rea-life study investigates the potential of biologic therapies as a primary treatment for CRSwNP, focusing on multiple clinical and patient-reported outcomes.
MATERIALS AND METHODS: This prospective real-life study included 25 patients with severe CRSwNP, treated with mepolizumab and dupilumab indicated specifically for CRSwNP rather than associated comorbidities. Evaluations occurred at baseline and 1, 3, 6, and 12 months post-treatment, using VAS, SNOT22, and NOSE questionnaires, nasal polyp size (NPS), Lund-Kennedy scores, and BOT-8 smell tests. We also collect the data of the blood eosinophils levels before and after the treatment. Adverse events were monitored.
RESULTS: Patients (mean age 49; 75% male; 75% N-ERD) experienced significant improvements. By 12 months, VAS scores decreased from 8.5 to 2.1, SNOT22 from 61.3 to 11, and NOSE from 69.5 to 8. Other measures, including NPS and BOT-8, also improved substantially. Specific descriptive results for each drug are also presented separately. No adverse effects were reported.
CONCLUSIONS: Biologic therapy (mepolizumab and dupilumab) as a primary treatment for CRSwNP demonstrated significant efficacy, reducing the need for surgical interventions and signaling a shift toward non-surgical management.
MATERIALS AND METHODS: This prospective real-life study included 25 patients with severe CRSwNP, treated with mepolizumab and dupilumab indicated specifically for CRSwNP rather than associated comorbidities. Evaluations occurred at baseline and 1, 3, 6, and 12 months post-treatment, using VAS, SNOT22, and NOSE questionnaires, nasal polyp size (NPS), Lund-Kennedy scores, and BOT-8 smell tests. We also collect the data of the blood eosinophils levels before and after the treatment. Adverse events were monitored.
RESULTS: Patients (mean age 49; 75% male; 75% N-ERD) experienced significant improvements. By 12 months, VAS scores decreased from 8.5 to 2.1, SNOT22 from 61.3 to 11, and NOSE from 69.5 to 8. Other measures, including NPS and BOT-8, also improved substantially. Specific descriptive results for each drug are also presented separately. No adverse effects were reported.
CONCLUSIONS: Biologic therapy (mepolizumab and dupilumab) as a primary treatment for CRSwNP demonstrated significant efficacy, reducing the need for surgical interventions and signaling a shift toward non-surgical management.