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Mepolizumab, a humanized anti–IL-5 mAb, as a treatment option for severe nasal polyposis



Mepolizumab, a humanized anti–IL-5 mAb, as a treatment option for severe nasal polyposis

Philippe Gevaert MD, Nicholas Van Bruaene MD, Tom Cattaert PhD, Kristel Van Steen PhD, Thibaut Van Zele MD PhD, Frederic Acke MD, Natalie De Ruyck MSc, Katrien Blomme MSc, Ana R. Sousa PhD, Richard P. Marshall MD PhD, Claus Bachert, MD, PhD

The Journal of Allergy and Clinical immunology,
128:5, September 29, 2011

Mepolizumab, a humanized anti–IL-5 mAb, as a treatment option for severe nasal polyposis

Background
Approximately 85% of nasal polyps (NPs) in white subjects are characterized by prominent eosinophilia. IL-5 is the key driver of eosinophilic differentiation and survival.

Objective
We sought to investigate the therapeutic potential of inhibiting IL-5 with a humanized mAb as treatment for severe nasal polyposis.

Methods
Thirty patients with severe nasal polyposis (grade 3 or 4 or recurrent after surgery) refractory to corticosteroid therapy were randomized in a double-blind fashion to receive either 2 single intravenous injections (28 days apart) of 750 mg of mepolizumab (n = 20) or placebo (n = 10). Change from baseline in NP score was assessed monthly until 1 month after the last dose (week 8). Computed tomographic scans were also performed at week 8.

Results
Twelve of 20 patients receiving mepolizumab had a significantly improved NP score and computed tomographic scan score compared with 1 of 10 patients receiving placebo at week 8 versus baseline.

Conclusion
Mepolizumab achieved a statistically significant reduction in NP size for at least 1 month after dosing in 12 of 20 patients. IL-5 inhibition is a potential novel therapeutic approach in patients with severe eosinophilic nasal polyposis.







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Prepared by: Dr. Awss Zidan






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