(1203) Assessment of Patient Response After 12-Month Treatment With Biologics for Chronic Rhinosinusitis With Nasal Polyps

Introduction: Chronic Rhinosinusitis with nasal polyps (CRSwNP) is mainly associated with TH2 inflammatory reaction. It coexists with asthma in 30-70% of cases and shares a common pathophysiological cascade. Mepolizumab is an IL-5 antagonist monoclonal antibody, which inhibits TH2 inflammatory response. Best suited candidates for this type of treatment are focus of research. The aim of this study is to evaluate clinical response of CRSwNP with/without mild asthma after 12 month administration of anti-IL5 therapy.

Methods: In total, 55 patients fullfilled the EPOS2023 criteria for anti-IL5 therapy, and have been screened prospectively between May of 2022 and December of 2023. Of them, 43 had CRSwNP with asthma and 12 CRSwNP without asthma. A total of 46 patients are under treatment today and 9 have stopped mepolizumab. All patients are clinically evaluated before, in 6 months, and 12 months of anti-il5 treatment, with nasal endoscopy, nasal polyp score (NPS), VAS score, SNOT-22, and Sniffin’ Sticks 12.

Results: In total, 15 patients have completed 12 months, and 24 did 6 months of mepolizumab. Endoscopic surgery was underwent by 33 before the initiation and 8 during treatment. At screening, 77% had NPS 4-8 and 38% had 0. Sniffin' Sticks were 1-5 for 22% and 6-12 for 40% of patients. VAS score before treatment was 7-10 in more than 40% and SNOT-22 was over 40 in more than 80% of cases. During the follow up visits at 6 and 12 months, more than 50% of patients showed increase of 2-4 points on Sniffin' Sticks and most of them had improvement of SNOT-22 score of at least 5 points, without a remarkable difference in NPS.

Conclusions: The 12-month anti-IL5 treatment for CRSwNP, seems to improve quality of life and olfaction scores, but not significantly the endoscopic findings. Further research is needed to determine clinical factors that may predict response to anti-il5 therapy.