Mepolizumab for the treatment of chronic rhinosinusitis with nasal polyps in adults

IntroductionThe treatment paradigm for chronic rhinosinusitis with nasal polyps (CRSwNP) is complex, consisting of a combination of conservative, medical and surgical management. High rates of recurrence despite current standard of care has led to the search for treatments that can improve outcomes and limit the treatment burden for patients living with this chronic condition.Areas coveredEosinophils are granulocytic white blood cells that proliferate as part of the innate immune response. IL5 is an inflammatory cytokine implicated in the development of eosinophil-associated diseases that has emerged as a target for biologic therapy. Mepolizumab (NUCALA) is a humanized antiIL5 monoclonal antibody that represents a novel therapeutic approach to CRSwNP. The results of multiple clinical trials are encouraging but its real-world implementation requires a thorough cost-benefit analysis across a range of clinical situations.Expert opinion: Mepolizumab is an emerging biologic therapy that shows promising potential for the treatment of CRSwNP. It appears to provide both objective and subjective improvement as an addon therapy to standard of care treatment. Its specific role in treatment algorithms remains a topic of discussion. Future research surrounding its efficacy and cost effectiveness as compared to alternative options is needed.