Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 128, Issue 5, Pages 989-U428Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2011.07.056
Keywords
Anti-IL-5; mepolizumab; eosinophils; chronic rhinosinusitis; nasal polyposis
Categories
Funding
- GlaxoSmithKline [CRT110178]
- Research Foundation Flanders (FWO-Vlaanderen)
- Interuniversity Attraction Poles Programme
- European Community under the PASCAL2 Network of Excellence [IST-2007-216886]
- GlaxoSmithKline
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Background: Approximately 85% of nasal polyps (NPs) in white subjects are characterized by prominent eosinophilia. IL-5 is the key driver of eosinophilic differentiation and survival. Objective: We sought to investigate the therapeutic potential of inhibiting IL-5 with a humanized mAb as treatment for severe nasal polyposis. Methods: Thirty patients with severe nasal polyposis (grade 3 or 4 or recurrent after surgery) refractory to corticosteroid therapy were randomized in a double-blindfashion to receive either 2 single intravenous injections (28 days apart) of 750 mg of mepolizumab (n = 20) or placebo (n = 10). Change from baseline in NP score was assessed monthly until 1 month after the last dose (week 8). Computed tomographic scans were also performed at week 8. Results: Twelve of 20 patients receiving mepolizumab had a significantly improved NP score and computed tomographic scan score compared with 1 of 10 patients receiving placebo at week 8 versus baseline. Conclusion: Mepolizumab achieved a statistically significant reduction in NP size for at least 1 month after dosing in 12 of 20 patients. IL-5 inhibition is a potential novel therapeutic approach in patients with severe eosinophilic nasal polyposis. (J Allergy Clin Immunol 2011;128:989-95.)
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