A growing body of real-world evidence is cementing the role of biologics in treating chronic rhinosinusitis with nasal polyps (CRSwNP) — a condition that causes persistent nasal blockage, smell loss, and significantly reduced quality of life. The largest real-world mepolizumab study to date (the MEPOREAL trial, n=621) found that 12 months of treatment slashed nasal polyp scores in half and cut SNOT-22 quality-of-life scores by nearly two-thirds. A separate Spanish cohort study (n=96) and a global dupilumab registry (n=691, followed up to 24 months) echoed these findings, with both biologics delivering sustained improvements in nasal congestion, smell, and overall symptom burden.

Patients with comorbid asthma appeared to benefit even more from mepolizumab, showing significantly greater improvements in quality of life, nasal obstruction, and sleep disturbances. Dupilumab's registry data showed that the share of patients reporting "no symptoms" jumped from just 3.3% at baseline to nearly 43% at 24 months — a striking turnaround.

Key Takeaways

• Mepolizumab (MEPOREAL): nasal polyp score dropped from 6 → 3; SNOT-22 from 59 → 21; blood eosinophils from 600 → 60 cells/μL (all P < .0001)
• 42% of mepolizumab patients achieved disease control; 20% were progressing toward remission at 12 months
• Dupilumab: 42.9% of patients reported "no symptoms" at 24 months, up from 3.3% at baseline
• Smell dysfunction and polyp burden at baseline predicted mepolizumab treatment outcomes

Why it matters: These converging real-world datasets give clinicians stronger confidence that biologic therapy can deliver meaningful, durable relief for patients with severe CRSwNP — moving the conversation from clinical trials to everyday practice.