BACKGROUND: The SYNAPSE phase 3 study demonstrated that mepolizumab significantly improves nasal polyp score (NPS), quality of life and symptom severity in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). OBJECTIVE: We aimed to evaluate mepolizumab effectiveness in a real-world cohort from 12 tertiary centers in 6 European countries. METHODOLOGY: A retrospective analysis was conducted in 110 CRSwNP patients (comorbid asthma: 86.4%). CRS-related outcomes were analyzed at baseline, 24 and 52 weeks of mepolizumab. Treatment response was evaluated based on EUFOREA 2021 criteria. RESULTS: Significant improvements in NPS, Sinonasal Outcome Test-22 (SNOT-22), and visual analog scale (VAS) symptom scores were observed at 24 and 52 weeks compared to baseline. Further improvement between weeks 24 and 52 was observed for NPS and SNOT-22. Asthma Control Test (ACT) also improved significantly by week 24 (ACT score ≥ 20: 64.5%). At least one response criterion (change in SNOT-22 ≥ 8.9, NPS ≥ 1, VAS total sinus symptoms ≥ 20, VAS nasal blockage ≥ 20, VAS loss of smell ≥ 20) was met by 85.6% and 78.7% of patients at 24 and 52 weeks, respectively. A more stringent composite response (SNOT-22 < 30, NPS < 4, VAS total sinus symptoms < 50, and VAS nasal blockage < 50) was achieved in 18.3% and 44.6% of patients at 24 and 52 weeks, respectively. CONCLUSION: Mepolizumab demonstrated clinically meaningful benefits in a real-world CRSwNP population, with nearly half of patients achieving a beneficial composite treatment response by week 52. Notably, progressive improvements between weeks 24 and 52 underscore the value of prolonged therapy and the importance of evaluating treatment response at one year.

Allergology Department Hospital Universitario de Terrassa Barcelona Spain

Clinic for ENT diseases and Head and Neck Surgery University Clinic Münster Münster Germany

Department of Clin Pharm and Pharmacol University Groningen University Medical Center Groningen Groningen the Netherlands

Department of General ORL Head and Neck Surgery Medical University of Graz Graz Austria

Department of Life Sciences Health and Health Professions Link Campus University Rome Italy

Department of Microbiology Immunology and Transplantation Allergy and Clinical Immunology Research Group KU Leuven Leuven Belgium

Department of Neurosciences Experimental Otorhinolaryngology Rhinology Research KU Leuven Leuven Belgium

Department of Oral and Maxillofacial Sciences Sapienza University Rome Italy

Department of Otorhinolaryngology 1st Affiliated Hospital Sun Yat Sen University International Airway Research Center Guangzhou China

Department of Otorhinolaryngology Head and Neck Surgery UZ Leuven Leuven Belgium

Department of Otorhinolaryngology Head and Neck Surgery Vienna General Hospital Medical University of Vienna Vienna Austria

Department of Otorhinolaryngology Ordensklinikum Linz Linz Austria

Department of Otorhinolaryngology Universitätsklinikum Düsseldorf Dusseldorf Germany

Department of Respiratory Medicine 1st Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic

Galenus Health Tielrode Belgium

Otorhinolaryngology Department Hospital Universitari Germans Trias i Pujol Barcelona Spain

Otorhinolaryngology Department Rhinology Unit and Smell Clinic and Skull Base Surgery Unit Hospital Clinic Barcelona Universitat de Barcelona IDIBAPS CIBERES Barcelona Catalonia Spain

Otorhinolaryngology Head and Neck Department Huriez Hospital Centre Hospitalier Universitaire Lille Lille France

Rhinology Unit Otorhinolaryngology Department Hospital Universitari de Bellvitge Universitat de Barcelona IDIBELL Barcelona Catalonia Spain

Service d'Otorhinolaryngologie Cliniques Universitaires Saint Luc Brussels Belgium

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