Dupilumab versus omalizumab in patients with chronic rhinosinusitis with nasal polyps and coexisting asthma…

Randomized trialThe Lancet. Respiratory medicine· Dec 2025

Dupilumab versus omalizumab in patients with chronic rhinosinusitis with nasal polyps and coexisting asthma (EVEREST): a multicentre, randomised, double-blind, head-to-head phase 4 trial.

Eugenio De Corso, G Walter Canonica, Enrico Heffler … Peter W Hellings

Rhinology & SinusRandomized trialTreatmentQ1IF 9.4

Dupilumab significantly improved nasal polyp scores more than omalizumab in chronic rhinosinusitis.

Dupilumab versus omalizumab in patients with chronic rhinosinusitis with nasal polyps and coexisting asthma (EVEREST): a multicentre, randomised, double-blind, head-to-head phase 4 trial.

Eugenio De Corso … Peter W Hellings

The Lancet · Dec 2025

Background

Chronic rhinosinusitis with nasal polyps (chronic rhinosinusitis with nasal polyps) is predominantly driven by type 2 inflammation.

Purpose

In EVEREST (EValuating trEatment RESponses of dupilumab versus omalizumab), the first head-to-head trial in respiratory biologics, we aimed to compare the efficacy and safety of dupilumab and omalizumab in patients with severe chronic rhinosinusitis with nasal polyps who had mild, moderate, or severe asthma.

Methods

And investigators were masked to the study drugs.

n = 819 individuals

Results

-1·60

dupilumab improved nasal polyp severity more than omalizumab

n = 819 individuals

More results

Improvements were significantly greater with dupilumab than omalizumab for all primary and secondary efficacy endpoints at week 24.

More results

115 (64%) of 179 participants in the dupilumab group and 116 (67%) of 173 participants in the omalizumab group reported treatment-emergent adverse events, the most common of which were nasopharyngitis, accidental overdose, headache, upper respiratory tract infection, and cough.

There were no deaths in the study.

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Conclusion · 1 of 2

Dupilumab was superior to omalizumab in patients with severe chronic rhinosinusitis with nasal polyps and coexisting asthma.

Conclusion · 2 of 2

These findings support the efficacy of dupilumab in patients with type 2 respiratory diseases versus an active biologic comparator, the known safety profiles of dupilumab and omalizumab, and could enable better treatment targeting for patients with chronic rhinosinusitis with nasal polyps and asthma in clinical practice.

Dupilumab versus omalizumab in patients with chronic rhinosinusitis with nasal polyps and coexisting asthma (EVEREST): a multicentre, randomised, double-blind, head-to-head phase 4 trial.

Dupilumab versus omalizumab in patients with chronic rhinosinusitis with nasal polyps and coexisting asthma (EVEREST): a multicentre, randomised, double-blind, head-to-head phase 4 trial.

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