Can mepolizumab help patients with asthma who also have nasal polyps?

Mepolizumab is a biologic drug that targets interleukin-5 (IL-5), a protein involved in type 2 inflammation common in both asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). For patients with both conditions, mepolizumab can improve nasal symptoms, reduce polyp size, and help control asthma. Studies show it works across different patient groups, including those with asthma or aspirin-exacerbated respiratory disease.

What the research says

In the SYNAPSE trial, mepolizumab reduced nasal polyp size and nasal obstruction in patients with severe CRSwNP, including those with asthma. Among 289 patients with asthma, 52.9% had at least a 1-point improvement in nasal polyp score with mepolizumab versus 29.5% with placebo ⁶. The REALITI-A study found that in patients with severe asthma and comorbid CRSwNP, mepolizumab reduced the rate of asthma exacerbations by 63% or more and improved asthma control and lung function ⁷. A separate trial showed that adding mepolizumab to functional endoscopic sinus surgery (FESS) improved lung function (FEV1 increased by 3.4%) and symptoms more than mepolizumab alone ³. Systematic reviews confirm that mepolizumab is effective for CRSwNP and can improve quality of life and reduce the need for surgery or corticosteroids ⁴⁵. Another review highlights that anti-IL-5 biologics like mepolizumab are approved for both severe eosinophilic asthma and CRSwNP ².

What to ask your doctor

• Is mepolizumab a good option for my asthma and nasal polyps together?
• How does mepolizumab compare to other biologics like dupilumab or omalizumab for my condition?
• What are the potential side effects and how long would I need treatment?
• Will mepolizumab reduce my need for other medications like oral steroids or sinus surgery?
• How will we monitor my response to treatment, including nasal symptoms and asthma control?