Drug1st-line biologic line
Mepolizumab
Anti–IL-5 monoclonal antibody
- Response rate
- Significant NPS reduction
- Onset
- 4–8 weeks
- Route
- SC 100mg every 4 weeks
- Line
- 1st-line biologic
- IgM effect
- Reduces polyp score
- Evidence level
- green
Evidence summary
Neutralises IL-5, reducing eosinophil maturation and survival. SYNAPSE trial demonstrated significant reduction in polyp size and need for surgery. FDA-approved 2021 for CRSwNP. May be preferred in patients with high eosinophil counts and comorbid eosinophilic asthma.
Molecular targets
| Molecule | Role | Expression | Evidence |
|---|---|---|---|
| IL-5 | Eosinophil survival factor | Elevated | established |
| Eosinophils | Effector granulocytes | Massively infiltrated in tissue | established |