Dupilumab is superior to omalizumab in adults with chronic rhinosinusitis with nasal polyps and asthma

Dupilumab provided greater improvements in nasal polyp scores and sense of smell compared with omalizumab in patients with severe chronic rhinosinusitis with nasal polyps and comorbid asthma requiring inhaled corticosteroids.

Prof. Enrico Marco Heffler (Humanitas University, Italy) presented results from the EVEREST trial (NCT04998604), a randomised, phase 4 trial comparing 24 weeks of dupilumab versus omalizumab [1]. Participants enrolled in the trial were adults with severe chronic rhinosinusitis with nasal polyps and comorbid asthma treated with inhaled corticosteroids. The primary outcome was the change in nasal polyp score (NPS) and University of Pennsylvania Smell Identification Test (UPSIT) from baseline to week 24. In total, 360 participants were randomised 1:1 to dupilumab or omalizumab.

Following 24 weeks of treatment, dupilumab achieved a significantly greater reduction in NPS, with a least-squares mean difference of -1.60 in comparison to omalizumab, favouring dupilumab (95% CI -1.96 to -1.25; P<0.0001). Furthermore, improvements in sense of smell assessed by UPSIT also favoured dupilumab, with a least-squares mean difference of 8.0 (95% CI 6.3-9.7; P<0.0001). The safety profiles were comparable between groups, with 19.6% of dupilumab-treated participants and 21.4% of omalizumab-treated participants reporting treatment-related adverse events.

“This is the first head-to-head study of biologics in respiratory diseases,” concluded Prof. Heffler, “and dupilumab demonstrated superiority over omalizumab in patients with chronic rhinosinusitis with nasal polyps and asthma. This study supports the efficacy of dupilumab and confirms the established safety profile of both dupilumab and omalizumab.”

1. Peters A, et al. Efficacy and safety of dupilumab (DUP) vs omalizumab (OMA) in chronic rhinosinusitis with nasal polyps (CRSwNP) with asthma (EVEREST study). ERS Congress, 27 September–1 October 2025, Amsterdam, the Netherlands.

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Posted on 30 October 2025