Objective  To evaluate the efficacy, safety, and cost-effectiveness of mepolizumab in the treatment of refractory chronic rhinosinusitis with nasal polyps (CRSwNP), and to provide evidence for clinical application.

Methods  A rapid health technology assessment (HTA) was conducted to systematically searched electronic databases including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, WanFang Data, VIP, and SinoMed, as well as official websites of overseas HTA institutions. The search covered HTA reports, systematic reviews/Meta-analyses and pharmacoeconomic studies focusing on mepolizumab for the treatment of CRSwNP, with the retrieval time from the inception to July 1, 2025. After data extraction and quality evaluation, a descriptive analysis was performed on the outcomes of the included studies.

Results  A total of 11 studies were included, comprising 1 HTA report, 8 systematic reviews/Meta-analyses, and 2 pharmacoeconomic studies; in terms of efficacy, mepolizumab significantly improved nasal polyp scores, imaging scores, olfactory function and quality of life versus placebo, while versus other biologics, it achieved the optimal nasal polyp score improvement, showed inferior olfactory function improvement to dupilumab and had inconsistent quality of life evaluation results; regarding safety, no statistically significant differences were observed in the incidences of adverse and serious adverse reactions of mepolizumab compared with placebo or other biologics; economically, mepolizumab had no economic advantages over other biologics.

Conclusion  Mepolizumab demonstrates favorable efficacy and safety profiles, providing a valuable treatment alternative for patients with CRSwNP. However, its cost-effectiveness still needs further research based on China's medical environment.

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