Real-World Study: Mepolizumab & Omalizumab Reduce Nasal Polyp Scores in Severe CRSwNP

Manon Blauwblomme, MD

Credit: LinkedIn

A real-world study found that mepolizumab and omalizumab had significant reductions in nasal polyp scores over 6 months among patients with severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP).¹ The findings are presented as a late breaker at the 2025 American Academy of Allergy, Asthma, & Immunology (AAAAI) annual meeting in San Deigo from February 28 through March 3.

In recent years, clinical trials have shown the effectiveness of monoclonal antibodies for severe asthma and CRSwNP. For instance, 2 randomized phase 3 trials, POLYP 1 and POLYP 2, found omalizumab signficantly improved endoscopic, clinical, and patient-reported outcomes in severe CRSwNP with inadequate response to intranasal corticosteroids.² Patients on omalizumab had signficantly improved SNOT-22 scores, University of Pennsylvania Smell Identification Test score, sense of smell postnasal drip, and runny nose, compared with placebo.

Despite the promising results of POLYP 1 and POLYP 2, monoclonal antibodies have limited real-world evidence on their effectiveness for treating CRSwNP.

Investigators, led by Manon Blauwblomme, MD, Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium, conducted a retrospective study to examine the effectiveness of mepolizumab and omalizumab over 12 months in patients with severe uncontrolled CRSwNP.¹ The study included 56 patients with available data on nasal polyp scores, rescue medication usage, olfactory function tests, and symptom questionnaires.

Among the 56 patients, 23 took omalizumab, and 33 took mepolizumab. The mean age of the sample was 51.2 years, and 62.5% of participants were male.

Participants on omalizumab and mepolizumab demonstrated significant reductions in nasal polyp scores over 6 months, with no differences between treatments (P = .317). Although patients on mepolizumab had greater baseline UPSIT scores, both patients on mepolizumab and omalizumab had a non-significant UPSIT increase over 12 months.

The study did find mepolizumab provided greater improvement in SNOT-22 scores compared with omalizumab (P = .033). However, both mepolizumab and omalizumab brought significant reduction at visits 2 and 3.

Furthermore, the team observed no significant difference between treatments in Good to Excellent responder rates at visit 2 (P = .0256).

“Mepolizumab led to greater improvements in symptom scores (SNOT-22) than Omalizumab, but olfactory function gains were modest and non-significant in both groups,” investigators wrote. “These findings support the effectiveness of both biologics in CRSwNP, with potential symptom relief advantages for Mepolizumab.”

References

1. Blauwblomme, M, Gevaert, Ph, Brusselle, G, et al. Real-Life Effectiveness of Mepolizumab and Omalizumab in Sever Uncontrolled Chronic Rhinosinusitis with Nasal Polyps: A Prospective Study. Journal of Allergy and Clinical Immunology, Volume 155, Issue 2, AB456

2. Gevaert P, Omachi TA, Corren J, Mullol J, Han J, Lee SE, Kaufman D, Ligueros-Saylan M, Howard M, Zhu R, Owen R, Wong K, Islam L, Bachert C. Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials. J Allergy Clin Immunol. 2020 Sep;146(3):595-605. doi: 10.1016/j.jaci.2020.05.032. Epub 2020 Jun 7. Erratum in: J Allergy Clin Immunol. 2021 Jan;147(1):416. doi: 10.1016/j.jaci.2020.11.003. PMID: 32524991.