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
Trial phase
Phase 4

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.

Approved indications

Conditions for which Mepolizumab has regulatory approval (not specific to rare diseases covered here):

Severe Eosinophilic AsthmaEosinophilic Granulomatosis with PolyangiitisChronic Rhinosinusitis with Nasal PolypsHypereosinophilic Syndrome

Drug identifiers

DrugBankDB11603
ATC CodeR03DX09
Open TargetsCHEMBL1201832

Molecular targets

MoleculeRoleExpressionEvidence
IL-5Eosinophil survival factorElevatedestablished
EosinophilsEffector granulocytesMassively infiltrated in tissueestablished

Sources (2)

DetailsHan JK et al. (2021) Mepolizumab for CRSwNP (SYNAPSE): a randomised, double-blind, placebo-controlled, phase 3 trialDOI
DetailsFokkens WJ et al. (2020) European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020)DOI