NUCALA REDUCED STEROID USE FOR NASAL POLYPS

PROVEN STEROID REDUCTION1

42% reduction in need for SCS vs placebo for patients with nasal polyps infographic

   

Secondary endpoint: Proportion of patients requiring SCS for nasal polyps up to Week 52; NUCALA + SOC (n=52/206) vs placebo + SOC (n=74/201), OR: 0.58; P=0.02.

SUBGROUP OF PATIENTS WITH 1 PRIOR NASAL POLYP SURGERY2,3

63% reduction in need for SCS vs placebo in patient subgroup with 1 prior nasal polyp surgery infographic

   

Proportion of patients requiring SCS for nasal polyps up to Week 52, for 1 prior surgery: NUCALA (n=20/108) vs placebo (n=29/81); OR: 0.37 (95% CI: 0.18, 0.76).

  • 2 prior surgeries: NUCALA (n=14/47) vs placebo (n=14/47); OR: 1.77 (95% CI: 0.60, 5.19).
  • >2 prior surgeries: NUCALA (n=18/51) vs placebo (n=31/73); OR: 0.55 (95% CI: 0.22, 1.37).

Proportion of patients requiring SCS for nasal polyps up to Week 52, for 1 prior surgery: NUCALA (n=20/108) vs placebo (n=29/81); OR: 0.37 (95% CI: 0.18, 0.76).

Post hoc analysis. Results are descriptive.

SYNAPSE study designkeyboard_arrow_right

CI=confidence interval; OR=odds ratio; SCS=systemic corticosteroid; SOC=standard of care.

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INDICATIONS & IMPORTANT SAFETY INFO

INDICATIONS

IMPORTANT SAFETY INFORMATION

INDICATIONS

NUCALA is indicated for the: 

  • add-on maintenance treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) in adult patients aged 18 years and older with inadequate response to nasal corticosteroids.
  • add-on maintenance treatment of adult and pediatric patients aged 6 years and older with severe asthma and with an eosinophilic phenotype. NUCALA is not indicated for the relief of acute bronchospasm or status asthmaticus.
  • add-on maintenance treatment of adult patients with inadequately controlled chronic obstructive pulmonary disease (COPD) and an eosinophilic phenotype. NUCALA is not indicated for the relief of acute bronchospasm.
  • treatment of adult patients with eosinophilic granulomatosis with polyangiitis (EGPA).
  • treatment of adult and pediatric patients aged 12 years and older with hypereosinophilic syndrome (HES) for greater than or equal to 6 months without an identifiable non-hematologic secondary cause.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

Known hypersensitivity to mepolizumab or excipients.

 

WARNINGS AND PRECAUTIONS

Hypersensitivity Reactions

Hypersensitivity reactions (eg, anaphylaxis, angioedema, bronchospasm, hypotension, urticaria, rash) have occurred with NUCALA. These reactions generally occur within hours of administration but can have a delayed onset (ie, days). Discontinue if a hypersensitivity reaction occurs.

 

Acute Symptoms of Asthma or COPD or Acute Deteriorating Disease

NUCALA should not be used to treat acute symptoms or acute exacerbations of asthma or COPD, or acute bronchospasm.

 

Opportunistic Infections: Herpes Zoster

Herpes zoster infections have occurred in patients receiving NUCALA. Consider vaccination if medically appropriate.

 

Reduction of Corticosteroid Dosage

Do not discontinue systemic or inhaled corticosteroids abruptly upon initiation of therapy with NUCALA. Decreases in corticosteroid doses, if appropriate, should be gradual and under the direct supervision of a physician. Reduction in corticosteroid dose may be associated with systemic withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy.

 

Parasitic (Helminth) Infection

Treat patients with pre-existing helminth infections before initiating therapy with NUCALA. If patients become infected while receiving NUCALA and do not respond to anti-helminth treatment, discontinue NUCALA until infection resolves.

 

ADVERSE REACTIONS

Most common adverse reactions (≥5%):

  • Severe asthma trials: headache, injection site reaction, back pain, fatigue
  • CRSwNP trial: oropharyngeal pain, arthralgia
  • COPD trials: back pain, diarrhea, cough
  • EGPA and HES trials (300 mg of NUCALA): most common adverse reactions were similar to severe asthma

Systemic reactions, including hypersensitivity, occurred in clinical trials in patients receiving NUCALA. Manifestations included rash, pruritus, headache, myalgia, flushing, urticaria, erythema, fatigue, hypertension, warm sensation in trunk and neck, cold extremities, dyspnea, stridor, angioedema, and multifocal skin reaction. A majority of systemic reactions were experienced the day of dosing.

 

USE IN SPECIFIC POPULATIONS

The data on pregnancy exposures are insufficient to inform on drug-associated risk. Monoclonal antibodies, such as mepolizumab, are transported across the placenta in a linear fashion as the pregnancy progresses; therefore, potential effects on a fetus are likely to be greater during the second and third trimesters.

 

Please see full Prescribing Information and Patient Information for NUCALA.

PMUS-MPLWCNT240086 May 2025

To report SUSPECTED ADVERSE REACTIONS, contact GSK at gsk.public.reportum.com or 1-888-825-5249 or
FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

References

  1. Han JK, Bachert C, Fokkens W, et al. Mepolizumab for chronic rhinosinusitis with nasal polyps (SYNAPSE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Respir Med. 2021;9(10):1141-1153.
  2. Chupp G, Alobid I, Lugogo NL, et al. Mepolizumab reduces systemic corticosteroid use in chronic rhinosinusitis with nasal polyps [published online ahead of print, August 14, 2023]. J Allergy Clin Immunol Pract. 2023;S2213-2198(23)00918-2.
  3. Data on file, GSK.