Photo Credit: iStock.com/Alena Butusava

Regardless of the presence of nasal polyps and aeroallergen sensitivity, patients with severe eosinophilic asthma can benefit from treatment with mepolizumab.

Patients with severe eosinophilic asthma can benefit from treatment with mepolizumab regardless of the presence of nasal polyps and aeroallergen sensitivity, according to real-world findings published in Allergy and Asthma Proceedings.

However, treatment responses varied among patients, and researchers noted that nasal polyps (NPs) and aeroallergen sensitivity impacted the extent of improvement in certain clinical measurements.

The retrospective study included 71 patients with severe eosinophilic asthma treated with 100 mg mepolizumab every 4 weeks for at least 6 months. Researchers divided patients into two groups based on the presence of nasal polyps. Each group was further divided into subgroups: those with and without aeroallergen sensitivity.

In the study population, 36 patients had nasal polyps; nearly the same number—35—did not. Among those with nasal polyps, 14 had aeroallergen sensitivity, while 22 did not. In the group without nasal polyps, 17 had aeroallergen sensitivity, while 18 did not.

Treatment Improves Multiple Outcomes

Before treatment, the presence of nasal polyps was significantly linked with more asthma exacerbations and oral corticosteroid use regardless of a patient’s aeroallergen sensitivity status (P<0.001). Asthma Control Test scores were lower in patients with nasal polyps and aeroallergen sensitivity, and the number of hospitalizations was significantly higher (P<0.001).

According to the study, asthma-related exacerbations, hospitalizations, and oral corticosteroid use decreased significantly in the four patient groups after treatment, while Asthma Control Test scores and pulmonary function significantly improved.

When researchers compared improvements across patient groups, they found several differences. Specifically, Asthma Control Test and hospitalization improvements were significantly greater in the group with nasal polyps and aeroallergen sensitivity than in other groups. Meanwhile, reductions in oral corticosteroid use were significantly higher in patients with nasal polyps, regardless of aeroallergen sensitivity status, compared with patients with neither nasal polyps nor aeroallergen sensitivity.

The findings indicate that patients with severe eosinophilic asthma benefited from mepolizumab regardless of the presence or absence of nasal polyps and aeroallergen sensitivity. However, the amount of improvement varied with asthma phenotype.

“Patients with NPs showed more favorable asthma outcomes, which supports the rationale for targeting treatable features, such as eosinophils, in patients with [severe eosinophilic asthma] and with NPs,” investigators wrote.