Adding Reslizumab May Benefit Uncontrolled Chronic Rhinosinusitis With Nasal Polyps

Adding intravenous reslizumab, an interleukin-5 antagonist monoclonal antibody, to mometasone furoate enhanced clinical benefits of the intranasal corticosteroid alone in patients with uncontrolled chronic rhinosinusitis with nasal polyps and peripheral eosinophilia, according to study results presented at the American College of Allergy, Asthma, & Immunology (ACAAI) Annual Scientific Meeting, held virtually from November 13 to 15.

This study followed previous research that demonstrated adding subcutaneous dupilumab to an intranasal corticosteroid therapy offers additive clinical benefits for this patient population. Investigators based this open-label trial on clinical observations that have suggested the addition of reslizumab may also offer additional efficacy in patients with suboptimally controlled chronic rhinosinusitis with nasal polyps with peripheral eosinophilia despite daily use of mometasone furoate.

A total of 60 adult patients with uncontrolled chronic rhinosinusitis with nasal polyps with peripheral eosinophilia (≥400 cells/mcL) were included. These patients were receiving 100 µg mometasone furoate twice daily at time of enrollment. Participants were randomly assigned to receive intravenous 3 mg/kg reslizumab every 4 weeks plus their mometasone furoate regimen or to continue with mometasone furoate monotherapy. The trial’s end points included flexible rhinopharyngolaryngoscopy, rhinomanometry, subjective symptom score, and sinuses computed tomography (CT) scan. The subjective symptom score included degree of congestion, rhinorrhea, and postnasal drip.

At 16 weeks, the mean efficacy measurements showed the combination group experienced significant improvement in all end points compared with the group who received mometasone furoate alone. In a between-groups analysis, significant improvement was observed in all monitored parameters. In the reslizumab plus mometasone furoate group, all end points significantly improved from baseline to 16 weeks.

Reference

Nsouli S. Reslizumab an interleukin-5 antagonist monoclonal antibody for uncontrolled chronic rhinosinusitis with nasal polyps. Presented at: the American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting (Virtual Experience). November 13-15, 2020. Abstract P509.