Document Type
Article
Publication Date
2026
DOI
10.4193/Rhin25.599
Publication Title
Rhinology
Volume
64
Issue
4
Pages
463-471
Abstract
BACKGROUND: Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often undergo multiple nasal surgeries. The Phase III SYNAPSE study (GSK ID:205687; NCT0308579) demonstrated that mepolizumab reduces the need for repeat surgery. We explored whether outcomes differed based on the number of prior surgeries. METHODOLOGY: This post hoc analysis of SYNAPSE stratified patients by history of 1 or more than 1 prior surgery. Patients were randomised to receive mepolizumab or placebo every 4 weeks, alongside standard of care, for 52 weeks. Outcomes included change from baseline in endoscopic nasal polyp (NP) score, visual analogue scale (VAS) scores for nasal obstruction, loss of smell and overall symptoms, Sino-Nasal Outcome Test-22 (SNOT-22), and time to repeat surgery and/or oral corticosteroid (OCS) use. RESULTS: 189 patients had 1 prior surgery (108 mepolizumab; 81 placebo) and 218 had more than 1 prior surgery (98; 120). In both subgroups, mepolizumab significantly improved mean changes versus placebo in NP, nasal obstruction, loss of smell VAS, overall symptom VAS, and SNOT-22. Significant reductions in risk of repeat surgery and requiring OCS were observed with mepolizumab versus placebo in patients with 1 prior surgery. CONCLUSIONS: Mepolizumab improves outcomes in patients with CRSwNP with one or multiple prior surgeries; however, may offer greater benefit when initiated after a single surgery.
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© 2026 The Authors.
The article is made freely available via the Rhinology website
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Original Publication Citation
Han, J. K., Mullol, J., Wagenmann, M., Walrave, L., Zhang, L., Sousa, A. R., Howarth, P., & Hopkins, C. (2026). Mepolizumab improves outcomes in patients with CRSwNP with one or more prior nasal polyp surgeries. Rhinology, 64(4), 463-471. https://doi.org/10.4193/Rhin25.599
Repository Citation
Han, J. K., Mullol, J., Wagenmann, M., Walrave, L., Zhang, L., Sousa, A. R., Howarth, P., & Hopkins, C. (2026). Mepolizumab improves outcomes in patients with CRSwNP with one or more prior nasal polyp surgeries. Rhinology, 64(4), 463-471. https://doi.org/10.4193/Rhin25.599
Graphical Abstract