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Purpose <p>To evaluate the real-world effectiveness of mepolizumab in patients with severe,uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP), assessing its impacton sinonasal symptoms, endoscopic findings, asthma control, systemic corticosteroiduse, and quality of life (QoL) over 12 months.</p> Methods <p>RINOSUR 2.0 was a prospective multicenter cohort study conducted in southernSpain. Ninety-six adult patients with severe, uncontrolled bilateral CRSwNP receivedmepolizumab as add-on therapy and were followed for 12 months. Outcomes wereassessed at baseline, 6, and 12 months. Primary endpoints included the 22-itemSinonasal Outcome Test (SNOT-22), visual analogue scale (VAS) symptom scores,and Nasal Polyp Score (NPS). Asthma control was evaluated using the Asthma ControlTest (ACT). Health utility was derived from SNOT-22 using a validated mappingalgorithm to estimate quality-adjusted life years (QALYs).</p> Results <p>Mean SNOT-22 improved from 65.2 + 19.9 at baseline to 29.9 + 19.7 at 12 months(change -35.3; p&lt;0.001), with 86.5% achieving the minimal clinically importantdifference. NPS decreased from 5.5 + 1.7 to 2.5 + 1.7 (p&lt;0.001). ACT increased from17.1 + 5.4 to 23.4 + 3.4 (p&lt;0.001). Health utility improved from 0.431 + 0.135 to 0.671+ 0.134, corresponding to a gain of 0.14 QALYs in the first year. Systemiccorticosteroid exposure was significantly reduced (p&lt;0.001). Clinical improvement wasindependent of prior surgical extent after adjustment for baseline severity. Treatmentwas well tolerated.</p> Conclusion <p>In routine practice, mepolizumab provides sustained improvements in QoL, endoscopicpolyp burden, and asthma control in severe CRSwNP, translating into clinicallymeaningful health utility gains.</p>

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Real-world impact of mepolizumab on symptom control and health utility in severe chronic rhinosinusitis with nasal polyps: the RINOSUR 2.0 multicenter cohort study

  • 期刊论文

  • 发表日期：

    2026年6月1日

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  • Rocío Corrales-Millán,
  • Juan Maza-Solano,
  • Juan Ramón Benito-Navarro,
  • Virginia García-García,
  • María José Gámiz-Maroto,
  • Juan Andrés Márquez-Moyano,
  • Lucía Prieto Sánchez de la Puerta,
  • Andrés Caballero-García,
  • Dionisio Guillamón-Fernández,
  • Manuel Ortiz-Rueda,
  • Dolores Alonso-Blanco,
  • Isabel María Reyes-Tejero,
  • Jean Paul Loaiza-Garreton,
  • Nicolás Müller-Locatelli,
  • Alfonso Cuvillo-Bernal

摘要

Purpose

To evaluate the real-world effectiveness of mepolizumab in patients with severe,uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP), assessing its impacton sinonasal symptoms, endoscopic findings, asthma control, systemic corticosteroiduse, and quality of life (QoL) over 12 months.

Methods

RINOSUR 2.0 was a prospective multicenter cohort study conducted in southernSpain. Ninety-six adult patients with severe, uncontrolled bilateral CRSwNP receivedmepolizumab as add-on therapy and were followed for 12 months. Outcomes wereassessed at baseline, 6, and 12 months. Primary endpoints included the 22-itemSinonasal Outcome Test (SNOT-22), visual analogue scale (VAS) symptom scores,and Nasal Polyp Score (NPS). Asthma control was evaluated using the Asthma ControlTest (ACT). Health utility was derived from SNOT-22 using a validated mappingalgorithm to estimate quality-adjusted life years (QALYs).

Results

Mean SNOT-22 improved from 65.2 + 19.9 at baseline to 29.9 + 19.7 at 12 months(change -35.3; p<0.001), with 86.5% achieving the minimal clinically importantdifference. NPS decreased from 5.5 + 1.7 to 2.5 + 1.7 (p<0.001). ACT increased from17.1 + 5.4 to 23.4 + 3.4 (p<0.001). Health utility improved from 0.431 + 0.135 to 0.671+ 0.134, corresponding to a gain of 0.14 QALYs in the first year. Systemiccorticosteroid exposure was significantly reduced (p<0.001). Clinical improvement wasindependent of prior surgical extent after adjustment for baseline severity. Treatmentwas well tolerated.

Conclusion

In routine practice, mepolizumab provides sustained improvements in QoL, endoscopicpolyp burden, and asthma control in severe CRSwNP, translating into clinicallymeaningful health utility gains.