The following article is a part of conference coverage from the American Academy of Allergy, Asthma & Immunology Annual Meeting, being held in Phoenix, Arizona, from February 25 to 28, 2022. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the AAAAI 2022 Virtual Annual Meeting.
The monoclonal antibody mepolizumab was effective in improving sense of smell in those patients with chronic rhinosinusitis with nasal polyps (CRSwNP) who had undergone less than 3 nasal surgeries. This was among the findings of an analysis of the phase 3 SYNAPSE clinical trial data being presented at the American Association of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting, held in Phoenix, Arizona, from February 25 to 28.
The SYNAPSE study (ClinicalTrials.gov Identifier: NCT03085797), a randomized, double-blind, placebo-controlled, 52-week clinical trial, was conducted in adult patients with severe bilateral CRSwNP who required repeat nasal polyps surgery. The investigators sought to evaluate the efficacy and safety of mepolizumab 100 mg administered subcutaneously every 4 weeks compared with standard of care (including intranasal corticosteroids). Changes from baseline in loss of smell Visual Analog Scale (VAS) symptom score (range, 0 to 10) and demographics of participants with a ≥3-point improvement in VAS score were assessed post hoc.
A total of 407 patients were enrolled in the study — 206 in the mepolizumab arm and 201 in the placebo arm. Participants had an impaired sense of smell at baseline (mean loss of smell VAS scores: mepolizumab, 9.63±0.830; placebo, 9.68±0.596). Between weeks 49 and 52, mepolizumab-treated participants exhibited significantly greater changes from baseline vs placebo-treated participants in their loss-of-smell VAS symptom scores (–3.00±0.231 vs –1.49±0.234, respectively; treatment difference –1.51; 95% CI, –2.15 to –0.87; P <.001) in a post-hoc analysis.
At weeks 49 to 52, a ≥3-point significant improvement in loss-of-smell VAS score was attained by 36% (74 of 206) of those in the mepolizumab group vs 19% (39 of 201) of those in the placebo group (odds ratio, 2.33; 95% CI, 1.48 to 3.68; P <.001). Participants in the mepolizumab arm were more likely to have undergone ≤2 surgeries prior to study entry, compared with those who did not achieve a ≥3-point improvement in loss-of-smell VAS symptom score (84% [62 of 74] vs 70% [93 of 132], respectively.
The researchers concluded that mepolizumab appears to be a good therapeutic option for the treatment of loss of smell among patients with CRSwNP who have not undergone more than 2 prior nasal surgeries.
Disclosure: None of the study authors has declared affiliations with biotech, pharmaceutical, and/or device companies.
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Mullol J, Lung V, Wagenmann M, et al. Mepolizumab induced loss of smell improvement in patients with chronic rhinosinusitis with nasal polyps from the SYNAPSE study. Presented at: American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting; February 25–28, 2022; Phoenix, AZ. Abstract 481.