Mepolizumab Can Reduce Systemic Corticosteroid Use in Treating Nasal Polyps

Mepolizumab can reduce systemic corticosteroid (SCS) use in treating nasal polyps among patients with chronic rhinosinusitis with nasal polyps (CRSwNP), according to study results presented at the American Thoracic Society (ATS) International Conference 2021, held virtually from May 14 to May 19, 2021.

This double-blind, randomized, placebo-controlled, multicenter study (SYNAPSE; ClinicalTrials.gov Identifier: NCT03085797) included 407 participants with acute, bilateral nasal polyps whose symptoms had persisted despite intranasal corticosteroid use. The participants received 52 weeks of 4 weekly subcutaneous mepolizumab 100 mg (n=206) or placebo (n=201) plus standard of care, which included prescription of SCS as required. Doses of SCS given within 1 week were treated as a single dose. Endpoints included the number of SCS doses, length of time on SCS treatment, time-to-first SCS course, and prednisolone-equivalent dose of oral corticosteroids (OCS) in mg/y.

Additional treatment with at least 1 dose of SCS was required among 25% (n=52) of participants given mepolizumab and 37% (n=74) of those given placebo, resulting in an odds ratio of 0.58 (95% CI, 0.36-0.92; P =.020) for SCS use with mepolizumab vs placebo. Mepolizumab was associated with a consistently lower likelihood of initial SCS dose from week 12 onwards. Although the number of days on SCS was similar between mepolizumab (21.9±45.8 days) and placebo (19.0±18.5 days) groups, those treated with mepolizumab required a lower mean total OCS dose (109±257 mg/y) than placebo (181±364 mg/y). Additionally, mepolizumab treatment resulted in a lower rate of ≥200 mg/y OCS use than placebo (19% [n=38] vs 31% [n=61]).

The study researchers concluded that individuals “with CRSwNP treated with mepolizumab were less likely to require SCS to control [nasal polyps] severity than patients in the placebo group.” Additionally, according to researchers, treatment with mepolizumab was associated with a lower rate of OCS use compared with placebo. Investigators indicated “support [for] the use of mepolizumab to reduce SCS use in patients with CRSwNP.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Chupp GL, Alobid I, Lugogo N, et al. Mepolizumab reduces systemic corticosteroid use in patients with chronic rhinosinusitis with nasal polyps. Presented at: the American Thoracic Society (ATS) International Conference 2021; May 14-19, 2021. Abstract A1344.