Favorable clinical efficacy of mepolizumab on the upper and lower airways in severe eosinophilic asthma: a 48-week pilot study.

Summary: Objective. Assessing efficacy of mepolizumab on the upper and lower airways in severe eosinophilic asthma patients. Patients and methods. This study was a 48-week prospective open-label analysis of mepolizumab in 11 asthmatics with chronic rhinosinusitis (CRS). It was administered every 4 weeks. Six patients were aspirin-exacerbated respiratory disease (AERD). Results. Blood eosinophil count was reduced after the first administration, and was continued until 48 weeks. The Sino-Nasal Outcome Test scores, the Lund-MacKay CT scoring, and forced expiratory volume in 1 second were improved. Symptom scores of anosmia and nasal congestion were not improved in the patients with AERD. All oral corticosteroid-dependent patients successfully withdrew from corticosteroids. Conclusions. This pilot study showed mepolizumab improved nasal symptoms and lung function in severe eosinophilic asthma patients with CRS, suggesting efficacy of mepolizumab on the upper and lower airway symptoms in eosinophilic asthma.