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Not yet recruitingNCT06258772MEPOREALUpdated Feb 14, 2024

Mepolizumab in the Treatment of Patients With Severe Uncontrolled CRSwNP: a Multicentric Real Life Observational Study

An observational study in Chronic Rhinosinusitis With Nasal Polyps, sponsored by Fondazione Policlinico Universitario Agostino Gemelli IRCCS. Not yet recruiting at 27 sites in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-02-14.

Sponsored by Fondazione Policlinico Universitario Agostino Gemelli IRCCS · Observational

Study type
Observational
Model
Cohort
Time perspective
Other
Enrollment
199
Ages
18 Years and older
Sex
All
01

Study summary

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a complex chronic inflammatory disease of the nasosinusal mucosa that has a significant negative impact on patients' quality of life.

In CRSwNP, chronic inflammation is primarily driven by type 2 pro-inflammatory interleukins (ILs )such as IL-5, IL-4, and IL-13 along- side high levels of eosinophils in the surrounding tissue. Mepolizumab is a targeted, humanized anti-IL-5 antibody that prevents IL-5 from binding to its receptor on eosinophils and selectively inhibits eosinophilic inflammation.

So far, randomized clinical trials have assessed efficacy and safety of Mepolizumab in a large number of patients, whereas evidences in real life clinical practice are limited to few monocentric series.

Herewith, we present a multicenter, observational, prospective/retrospective nationwide real-life study with the aim to confirm the effectiveness and the safety of Mepolizumab over the first year of treatment in a real life setting.

The primary objective of this study is to evaluate the reduction of dimension of nasal polyps and the improvement of quality of life in the patient measured through symptomatologic questionnaires.

The secondary objective is to evaluate improvements in terms of smell dysfunction, comorbidities, biomarkers (nasal cytology and blood eosinophilia), need of surgery or systemic steroids.

02

Conditions studied

  • Chronic Rhinosinusitis With Nasal Polyps
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Sampling method
Non-probability sample

Study population

We included all patients that were referred to Mepolizumab therapy, prescribed accordingly to the plan provided by AIFA

Inclusion criteria

  • Patients over 18 years of age who can sign a written informed consent Confirmed clinical / radiological diagnosis of chronic rhinosinusitis with diffuse naso-sinusal polyposis by nasal endoscopy and/or massive facial CT scan without contrast medium carried out within 6 months prior to the start of therapy;
  • Blood eosinophils >150
  • Severe disease stage, defined by Nasal Polyp Score (NPS) ≥ 5 or nasal obstruction symptom visual analogue scale (VAS) score of >5 and/or Sinonasal outcome tests-22 (SNOT-22) ≥ 50);
  • Inadequate symptom control with intranasal local corticosteroid therapy;
  • Failure of previous medical treatments (at least 2 cycles in the last year of systemic corticosteroid) and failure of previous surgical treatment through nasal endoscopic surgery (FESS), with no clinical benefit or postoperative complications.

Exclusion criteria

Exclusion Criteria:

  • Age \<18 years;
  • Patients undergoing immunosuppressive therapies;
  • Patients undergoing radio/chemotherapy treatments for cancer in the 12 months before the start of therapy;
  • Patients on concomitant long-term corticosteroid therapy for chronic autoimmune disorders.
04

Study design

Observational model
Cohort
Time perspective
Other
Enrollment
199 participants (estimated)
Patient registry
No

Groups and cohorts

  • Severe, uncontrolled CRSwNP patients in therapy with Mepolizumab

    Drug: Mepolizumab Auto-Injector

Interventions

  • DrugMepolizumab Auto-Injector

    Mepolizumab 100 mg in pre-filled injector

    Also known as: Mepolizumab 100 mg

05

What researchers measure

Primary outcomes

  1. Nasal Polyp Score

    Evaluation of polyps volume from 0 (minimum) to 4 (maximum) points for each nasal cavity. Reduced score indicates improvement

    Time frame: 24 months

  2. Sinonasal Outcome Test - 22

    Questionnaire measuring health-related quality of life. The score is from 0 (minimum) to 110 (maximum). Reduced score indicates improvement

    Time frame: 24 months

Secondary outcomes

  1. Visual Analogue Scale for nasal obstruction

    Evaluation of nasal obstruction from 0 (minimum) to 10 (maximum) ;reduced score indicates improvement

    Time frame: 24 moths

  2. Nasal Congestion Score (NCS); score (range 0-3);

    Evaluation of nasal congestion educed score indicates improvement

    Time frame: 24 months

  3. Visual Analogue Scale for smell

    Evaluation of olfaction impairment from 0 (minimum) to 10 (maximum); reduced score indicates improvement

    Time frame: 24 months

  4. Sniffing sticks identification test

    Test of nasal chemosensory performance based on pen-like odor dispensing devices. From 0 (minimum ) to 16 (maximum); increased score indicates improvement.

    Time frame: 24 months

  5. Change in blood eosinophil count

    Change in blood eosinophil count in a complete blood count (CBC)

    Time frame: 24 months

  6. Adherence to drug therapy with Mepolizumab

    Number of missing injection in a year

    Time frame: 24 months

  7. Need for rescue oral corticosteroids

    Number of oral corticosteroids cycles during therapy

    Time frame: 24 months

  8. Need for surgery

    Number of surgeries performed during therapy

    Time frame: 24 months

06

Study locations

27 sites
  • Ospedali PO di Venere e San Paolo
    Bari, Italy
  • Policlinico Universitario di Bari, Ospedale Giovanni XXIII,
    Bari, Italy
  • AUSL Bologna
    Bologna, Italy
  • ASST degli spedali civili di Brescia,
    Brescia, Italy
  • Azienda Ospedaliero Universitaria Policlinico - S. Marco,
    Catania, Italy
  • Azienda Ospedaliero Universitaria Careggi
    Firenze, Italy
  • Ospedale Policlinico San Martino,
    Genova, Italy
  • Ospedale Vito Fazzi, ASL Lecce
    Lecce, Italy
  • ASST Santi Paolo e Carlo
    Milano, Italy
    • Carlotta Pipolo · Contact
  • IRCCS Ca' Granda Ospedale Maggiore Policlinico
    Milano, Italy
  • IRCCS Ospedale San Raffaele
    Milano, Italy
  • Azienda Ospedaliero-Universitaria di Modena - Modena
    Modena, Italy
    • Daniela Lucidi · Contact
  • Azienda ospedaliera policlinico Federico II di Napoli
    Napoli, Italy
  • Ospedale Maggiore della Carità di Novara,
    Novara, Italy
  • Azienda Ospedaliera Universitaria San Luigi Gonzaga,
    Orbassano (TO), Italy
  • Azienda Ospedaliera Università di Padova
    Padova, Italy
  • Fondazione I.R.C.C.S. Policlinico San Matteo
    Pavia, Italy
    • Fabio Pagella · Contact
  • Azienda Ospedaliero-Universitaria Pisana - Pisa
    Pisa, Italy
  • Azienda USL - IRCCS di Reggio Emilia
    Reggio Emilia, Italy
  • Azienda Ospedaliera San Camillo-Forlanini
    Roma, Italy
  • Fondazione Policlinico Universitario A.Gemelli IRCCS
    Roma, Italy
  • Ospedaliero- Universitaria Policlinico Umberto I
    Roma, Italy
  • Policlinico Tor Vergata: Fondazione PTV
    Roma, Italy
  • Presidio Ospedaliero San Filippo Neri,
    Roma, Italy
  • Azienda Ospedaliero- Universitaria Senese
    Siena, Italy
  • i ASL ROMA 5 - Distretto Sanitario di Tivoli
    Tivoli, Italy
  • ASST sette laghi Varese,
    Varese, Italy
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT06258772
Lead sponsor
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Responsible party
DE CORSO EUGENIO (Principal Investigator, Fondazione Policlinico Universitario Agostino Gemelli IRCCS) — Principal investigator
First posted
Feb 14, 2024
Start date
Feb 5, 2024 (estimated)
Primary completion
Feb 1, 2025 (estimated)
Completion
Feb 1, 2026 (estimated)
Last update
Feb 14, 2024

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is not yet recruiting, as verified in Feb 2024. You cannot join it, but the record below documents what was studied.

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