Patients using mepolizumab (Nucala, GlaxoSmithKline) experienced significant improvement in nasal polyps, nasal obstruction, smell and overall symptoms.
RT’s Three Key Takeaways:
- Significant Reduction in Surgery Risk – Mepolizumab reduced the need for repeat sinus surgery by 73% in patients with one prior surgery and 39% in those with multiple surgeries.
- Improved Symptom Relief – Patients receiving mepolizumab showed significant improvements in nasal polyp size, nasal obstruction, sense of smell, and overall symptoms compared to a placebo.
- Lower Dependence on Oral Corticosteroids (OCS) – The treatment reduced the odds of requiring an OCS course by 63% in patients with one prior surgery and by 6% in those with multiple surgeries.
Mepolizumab significantly improved changes in nasal polyps (NP) for patients with chronic rhinosinusitis with nasal polyps compared to a placebo, according to research presented at the 2025 AAAAI / WAO Joint Congress.
In Phase III of the SYNAPSE trial researchers found that mepolizumab significantly reduces the risk of repeat sinus surgery in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). During the study, researchers compared the impact of mepolizumab in patients with prior nasal polyp (NP) surgery, randomizing patients 1:1 to receive 100mg of subcutaneous mepolizumab along with standard care. At week 52 of the study, key patient-reported outcomes and clinical endpoints were assessed after treatment.
In the research, 189 participants had one prior surgery, with 108 receiving mepolizumab and 81 receiving a placebo, and 218 participants had more than one prior surgery with 98 receiving mepolizumab and 120 receiving a placebo. In both prior surgery subgroups, mepolizumab significantly improved changes in nasal polyps (NP) compared to a placebo, as well as making significant improvements in a nasal obstruction visual analog scale (VAS) score, smell, overall symptoms and Sino-Nasal Outcome test compared to the placebo.
Researchers found that mepolizumab reduced the time to first surgery by 73% in the subgroup with one prior surgery and 39% in the subgroup with more than one surgery versus the placebo. Additionally, the study found a 63% reduction in the odds of requiring oral corticosteroid (OCS) course in the subgroup with one prior surgery and 6% in the subgroup of more than one prior surgery.
Mepolizumab significantly improves outcomes in patients with CRSwNP with one or more prior NP surgeries, with more pronounced benefits in surgery risk and OCS use in patients with one prior surgery.
