Mepolizumab, a humanized anti¨CIL-5 mAb, as a treatment option for severe nasal polyposis

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• 作者：Philippe Gevaert MD ; PhD^a ;   ; ^&lowast ; ;   ; ^{philippe.gevaert@UGent.be} ; Nicholas Van Bruaene MD^a ;   ; ^&lowast ; ; Tom Cattaert PhD^b ;   ; ^c ; Kristel Van Steen PhD^b ;   ; ^c ; Thibaut Van Zele MD ; PhD^a ; Frederic Acke MD^a ; Natalie De Ruyck MSc^a ; Katrien Blomme MSc^a ; Ana R. Sousa PhD^d ; Richard P. Marshall MD ; PhD^d ; Claus Bachert MD ; PhD^a
• 关键词：Anti&ndash ; IL-5 ; mepolizumab ; eosinophils ; chronic rhinosinusitis ; nasal polyposis
• 刊名：Journal of Allergy and Clinical Immunology
• 出版年：2011
• 出版时间：November 2011
• 年：2011
• 卷：128
• 期：5
• 页码：989-995.e8
• 全文大小：757 K

文摘

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.

Conclusion

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.