title: Mepolizumab, a humanized anti-IL-5 mAb, as a treatment option for severe nasal polyposis.
abstract: 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-blind fashion 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Upper Airways Research Laboratory, Department of Otorhinolaryngology, Ghent University, Ghent, Belgium. philippe.gevaert@UGent.be
authors.forename: Philippe
authors.initials: P
authors.lastname: Gevaert
authors.forename: Nicholas
authors.initials: N
authors.lastname: Van Bruaene
authors.forename: Tom
authors.initials: T
authors.lastname: Cattaert
authors.forename: Kristel
authors.initials: K
authors.lastname: Van Steen
authors.forename: Thibaut
authors.initials: T
authors.lastname: Van Zele
authors.forename: Frederic
authors.initials: F
authors.lastname: Acke
authors.forename: Natalie
authors.initials: N
authors.lastname: De Ruyck
authors.forename: Katrien
authors.initials: K
authors.lastname: Blomme
authors.forename: Ana R
authors.initials: AR
authors.lastname: Sousa
authors.forename: Richard P
authors.initials: RP
authors.lastname: Marshall
authors.forename: Claus
authors.initials: C
authors.lastname: Bachert
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D004311:Double-Blind Method; D047150:Eosinophil Cationic Protein / Q000032:analysis; D004802:Eosinophilia / Q000188:drug therapy; D005260:Female; D006801:Humans; D015848:Interleukin-5 / Q000037:antagonists & inhibitors* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000188:drug therapy* / Q000276:immunology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D015848:Interleukin-5; C434107:mepolizumab; D047150:Eosinophil Cationic Protein