Orlando Pietro, Vivarelli Emanuele, Minzoni Alberto, Licci Giuseppe, Accinno Matteo, Brugnoli Barbara, Matucci Andrea, Vultaggio Alessandra, Maggiore Giandomenico
Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla, 3, Florence, 50134, Italy.
Immunoallergology Unit, Careggi University Hospital, Florence, Italy.
Eur Arch Otorhinolaryngol. 2025 Jan;282(1):265-272. doi: 10.1007/s00405-024-09027-8. Epub 2024 Oct 15.
Mepolizumab was recently approved for treating Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) unresponsive to standard treatment or recurring after endoscopic sinus surgery (ESS). To date, few studies have assessed Mepolizumab's efficacy in severe type-2 CRSwNP. Our study aimed to analyze sinonasal outcomes in type-2 CRSwNP patients treated with 100 mg Mepolizumab administered subcutaneously every four weeks.
We conducted a retrospective study of patients with severe, recalcitrant CRSwNP treated with Mepolizumab. Demographic and clinical characteristics were collected, including age, sex, and comorbidities such as asthma, nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (NERD), and allergic rhinitis (AR), as well as the number of previous ESS procedures and the interval since the last one. Patients were evaluated at baseline and after one year for blood eosinophil count, nasal polyp score (NPS), modified Lund-Kennedy score (mLKS), olfactory function (using a VAS scale and a 16-item Sniffin' identification test), SNOT-22, and sinus opacification on CT scans. The need for rescue ESS or systemic corticosteroids (SCS), response to treatment, and side effects were also recorded.
Data from 27 patients were collected. After one year, all scores showed significant improvement. NERD was the only factor associated with a less favorable improvement in olfactory function. There were no side effects reported, although 2 patients discontinued Mepolizumab as they were considered "non-responders."
Mepolizumab is safe and effective in reducing the clinical, endoscopic, and radiological burden of disease, as well as in decreasing the need for salvage ESS or systemic steroids.
美泊利单抗最近被批准用于治疗对标准治疗无反应或在内镜鼻窦手术（ESS）后复发的慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）。迄今为止，很少有研究评估美泊利单抗在重度2型CRSwNP中的疗效。我们的研究旨在分析每四周皮下注射100mg美泊利单抗治疗的2型CRSwNP患者的鼻窦结局。
我们对接受美泊利单抗治疗的重度、顽固性CRSwNP患者进行了一项回顾性研究。收集了人口统计学和临床特征，包括年龄、性别以及合并症，如哮喘、非甾体抗炎药诱发的呼吸道疾病（NERD）和变应性鼻炎（AR），以及既往ESS手术的次数和距上次手术的时间间隔。在基线和一年后对患者进行评估，包括血液嗜酸性粒细胞计数、鼻息肉评分（NPS）、改良Lund-Kennedy评分（mLKS）、嗅觉功能（使用视觉模拟量表和16项嗅觉识别测试）、SNOT-22以及CT扫描上的鼻窦混浊情况。还记录了挽救性ESS或全身用糖皮质激素（SCS）的需求、治疗反应和副作用。
收集了27例患者的数据。一年后，所有评分均显示出显著改善。NERD是与嗅觉功能改善较差相关的唯一因素。尽管有2例患者因被认为是“无反应者”而停用美泊利单抗，但未报告有副作用。
美泊利单抗在减轻疾病的临床、内镜和影像学负担以及减少挽救性ESS或全身用类固醇的需求方面是安全有效的。
