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Peer-reviewedCC BY-NC-NDLaryngoscope investigative otolaryngology

No Effect of Preoperative Mepolizumab on Early Postoperative Healing After ESS for Severe CRSwNP

  • A. S. Homøe1
  • M. Høxbro1
  • J. Tidemandsen1
  • V. Backer1,2
  • E. Kiaer1
  • S. Scott1
  • N. Rubek3
  • K. Aanæs1
  1. 1Department of Otorhinolaryngology, Head and Neck Surgery and Audiology Copenhagen University Hospital Copenhagen Denmark
  2. 2Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
  3. 3Rhinoklinikken, Private Hospital Hellerup Denmark
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Abstract

Objective: To evaluate postoperative endoscopic mucosal healing 2 weeks after ESS in patients with severe CRSwNP treated with surgery alone versus surgery combined with biologics initiated 2 weeks preoperatively.

Methods: In this exploratory post hoc analysis, patients with severe CRSwNP were divided into two cohorts: ESS alone and ESS with preoperative mepolizumab initiated 2 weeks prior to surgery. Postoperative endoscopic video recordings obtained 2 weeks after ESS were anonymized and evaluated by four raters using blinded offline scoring. Healing was assessed using structured endoscopic domains (including discharge, edema, and scarring) and an overall endoscopic visual analogue scale (VAS 0–10). Inter‐rater reliability was assessed.

Results: The overall endoscopic VAS score did not differ between groups. Consistent with this, no differences were observed in endoscopic scores. Inter‐rater agreement was moderate for VAS, discharge, and edema, and low for scarring, reflecting inherent limitations of early postoperative endoscopic assessment.

Conclusion: In this exploratory analysis, preoperative mepolizumab was not associated with measurable differences in early postoperative endoscopic mucosal healing 2 weeks after ESS. These findings relate specifically to early postoperative mucosal appearance and should not be interpreted as evidence regarding the broader efficacy of biologic therapy or longer‐term postoperative outcomes. Larger prospective studies with longer follow‐up are warranted.

Level of Evidence: 2.

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Cite

BibTeXRIS
BibTeX
@article{homoe2026effect,
  title = {{No Effect of Preoperative Mepolizumab on Early Postoperative Healing After ESS for Severe CRSwNP}},
  author = {A. S. Homøe and M. Høxbro and J. Tidemandsen and V. Backer and E. Kiaer and S. Scott and N. Rubek and K. Aanæs},
  journal = {Laryngoscope investigative otolaryngology},
  year = {2026},
  month = oct,
  doi = {10.1002/lio2.70619},
  url = {https://europepmc.org/article/PMC/PMC13719286},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - No Effect of Preoperative Mepolizumab on Early Postoperative Healing After ESS for Severe CRSwNP
AU  - A. S. Homøe
AU  - M. Høxbro
AU  - J. Tidemandsen
AU  - V. Backer
AU  - E. Kiaer
AU  - S. Scott
AU  - N. Rubek
AU  - K. Aanæs
PY  - 2026
DA  - 2026/10/29
JO  - Laryngoscope investigative otolaryngology
DO  - 10.1002/lio2.70619
UR  - https://europepmc.org/article/PMC/PMC13719286
AB  - Objective: To evaluate postoperative endoscopic mucosal healing 2 weeks after ESS in patients with severe CRSwNP treated with surgery alone versus surgery combined with biologics initiated 2 weeks preoperatively.  Methods: In this exploratory post hoc analysis, patients with severe CRSwNP were divided into two cohorts: ESS alone and ESS with preoperative mepolizumab initiated 2 weeks prior to surgery. Postoperative endoscopic video recordings obtained 2 weeks after ESS were anonymized and evaluated by four raters using blinded offline scoring. Healing was assessed using structured endoscopic domains (including discharge, edema, and scarring) and an overall endoscopic visual analogue scale (VAS 0–10). Inter‐rater reliability was assessed.  Results: The overall endoscopic VAS score did not differ between groups. Consistent with this, no differences were observed in endoscopic scores. Inter‐rater agreement was moderate for VAS, discharge, and edema, and low for scarring, reflecting inherent limitations of early postoperative endoscopic assessment.  Conclusion: In this exploratory analysis, preoperative mepolizumab was not associated with measurable differences in early postoperative endoscopic mucosal healing 2 weeks after ESS. These findings relate specifically to early postoperative mucosal appearance and should not be interpreted as evidence regarding the broader efficacy of biologic therapy or longer‐term postoperative outcomes. Larger prospective studies with longer follow‐up are warranted.  Level of Evidence: 2.
SN  - 2378-8038
ER  -