Eosinophilic inflammation can drive recurrent nasal polyps

Recurrent nasal polyps and eosinophilic inflammation

Up to 90% of nasal polyps have predominantly eosinophilic inflammation
Up to 90% of nasal polyps have predominantly eosinophilic inflammation

*Based on studies that examined the presence of eosinophil leukocyte infiltration in nasal polyp biopsy tissue of patients in the US and Europe.1-4

Eosinophil-inflammation graph
Eosinophil-inflammation graph

Based on a retrospective single-center study to investigate the relationship between eosinophil density in nasal polyp tissue and recurrence in adults who underwent endoscopic sinus surgery for massive nasal polyposis (filled at least half of each nostril). Patients were categorized as higher density (>4 eosinophils/1000 μm2) or lower density (≤3 eosinophils/1000 μm2) by examining digital images taken at x400 magnification.4

NP=nasal polyp.

How NUCALA works to target eosinophils

NUCALA targets interleukin-5 (IL-5), the major cytokine responsible for the growth and differentiation, recruitment, activation, and survival of eosinophils.

NUCALA MOA diagram
 
 
 
 

 

NUCALA MOA diagram

The mechanism of action of mepolizumab in CRSwNP has not been definitively established.

NUCALA: Reduced blood eosinophil levels and maintained within normal* levels5,6

Reduced blood eosinophil levels line graph
Reduced blood eosinophil levels line graph
Lungs Icon

80%

reduction

in blood eosinophil levels with
NUCALA at Week 4, maintained
at 84% at Week 525,6

Mean blood eosinophil levels (NUCALA, placebo)

  • Baseline: 390 cells/μL, 400 cells/μL
  • At Week 52: 60 cells/μL, 360 cells/μL

All results are descriptive. The clinical significance of these pharmacodynamics data is unknown.
 

Note: Mean normal blood eosinophil levels in a general population of subjects without confounding factors have been reported as 100 cells/µL (range: 34-257) and 107 cells/µL (5th, 95th percentile: 30, 395); levels vary based on age, sex, environmental exposures, and comorbid conditions.7,8

Role of eosinophils in health and in nasal polyps

Eosinophils diagram
Eosinophils diagram

Role of eosinophils in maintaining health includes9:

  • Regulating the immune system
  • Tissue regeneration and repair
  • Host protection (eg, defending against parasitic infection)

Elevated eosinophils in nasal polyps are associated with1-4:

  • Inflammation
  • Greater likelihood of nasal polyp recurrence following surgical removal