Real-world two-year outcomes of mepolizumab in patients with chronic rhinosinusitis with nasal polyps and coexisting severe asthma
In brief
In 48 patients, mepolizumab cut asthma attacks from 0.7 to 0.1 yearly
Over two years, patients with nasal polyps and severe asthma also saw nasal symptom scores fall from 65.2 to 22.1 and asthma control scores rise from 16.6 to 22.7. Dual control of both conditions reached 42.1%, showing that sustained improvement did not mean most patients achieved control of both diseases; the findings come from a small observational cohort.
- Journal
- European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Q1)
- Published
- 3 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Juan Riestra-Ayora, Carlos Fernández-Navarro, Cristina Vaduva, Beatriz Rodríguez Jiménez, Lorena Martín Zaragoza, Eduardo Martín-Sanz, et al.
- PMID
- 42827160
- DOI
- 10.1007/s00405-026-10647-5
Why clinicians should know about it
- Picked for Otorhinolaryngology (paper of the day, 5 October 2026): Real‑world mepolizumab outcomes in CRSwNP + asthma
Abstract
PURPOSE: Chronic rhinosinusitis with nasal polyps (CRSwNP) and severe asthma frequently coexist as manifestations of type 2 airway inflammation. Although mepolizumab has demonstrated efficacy in both conditions, long-term real-world data on integrated airway disease control remain limited. We evaluated the long-term effectiveness of mepolizumab in patients with CRSwNP and coexisting severe asthma over 2 years. METHODS: We conducted a longitudinal real-world observational cohort study at a tertiary referral center. Baseline data were collected retrospectively, and follow-up assessments were prospectively recorded at 6, 12, and 24 months. Response-based endpoints assessed longitudinal improvement, whereas disease control reflected stabilization of disease burden at each follow-up, including dual airway disease control. RESULTS: 48 patients were included. Mepolizumab induced sustained improvement across both airway compartments. SNOT-22 scores improved from 65.2 to 22.1, while NPS decreased from 4.8 to 1.8 at 2 years. ACT scores increased from 16.6 to 22.7, exacerbation rates decreased from 0.7 to 0.1 events per patient-year, and systemic corticosteroid exposure decreased from 95.8% to 31%. Combined clinical-endoscopic CRSwNP response was achieved in 60.0%, 75.0%, and 70.6% at 6 months, 1 year, and 2 years, respectively. Dual airway disease control increased from 24.2% to 42.1%. CONCLUSIONS: Mepolizumab provides sustained long-term benefit in patients with CRSwNP and severe asthma. While clinical response occurs early and frequently, integrated dual airway disease control is achieved progressively and in a smaller proportion of patients.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.