touchRESPIRATORY coverage of EAACI 2025:
EVEREST (NCT04998604) was a randomized, double-blind, phase IIII study comparing the efficacy and safety of dupilumab with omalizumab in patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP) and coexisting asthma. In this interview, Dr Eugenio De Corso (Catholic University of the Sacred Heart, Milan, Italy) discusses the mechanism of action of dupilumab, and the aims, inclusion criteria and methodology of the EVEREST trial. Dr De Corso also covers the comparative primary and secondary endpoint results, the safety findings, and the impact this trial will have on clinical practice.
The abstract “Efficacy and safety of dupilumab versus omalizumab in patients with severe chronic rhinosinusitis with nasal polyps and coexisting asthma (EVEREST): Results from a prospective, head-to-head phase 4 trial.” was presented at EAACI 2025, Glasgow, 13–16 June 2025.
Q. What impact does CRSwNP have on the quality of life of patients, particularly those with coexisting asthma?
CRSwNP can impact numerous aspects of a patient’s life due to persistent symptoms such as nasal obstruction, congestion and smell loss. When untreated, the often-severe symptoms can lead to sleep disruptions and decreased productivity, and can prevent patients from enjoying food. For people with coexisting asthma, managing the conditions is even more difficult, and can decrease health-related quality of life.
Q. What is the mechanism of action of dupilumab and how does this target type-2 inflammation?
Dupilumab targets the IL-4 and IL-13 signalling pathways by binding to a common receptor subunit of IL-4 and IL-13 receptors. IL-4 and IL-13 are key and central drivers of type-2 inflammation that plays a major role in multiple related and often co-morbid diseases such as CRSwNP and asthma.
Q. What were the aims, inclusion criteria and methodology of the EVEREST trial?
The aim was to understand how two biologics, dupilumab and omalizumab, that have been on the market for a long time for CRSwNP and asthma, compare. The study included adults (≥18 years) with severe, uncontrolled CRSwNP and coexisting mild, moderate or severe asthma. Patients received dupilumab 300 mg every 2 weeks or omalizumab 75 to 600 mg every 2 or 4 weeks, which was added to background mometasone furoate nasal spray. Omalizumab dosing was determined based on body weight and serum total IgE levels as per the approved label. All endpoints were assessed at 24 weeks.
Q. What were the comparative primary and secondary endpoint results, and what was the safety profile of dupilumab?
Dupilumab outperformed omalizumab across all primary and secondary efficacy endpoints of CRSwNP and in all asthma-related endpoints. Specifically, dupilumab was superior to omalizumab in reducing nasal polyp size, improving the ability to identify different smells, reducing nasal congestion/obstruction, and improving loss of smell, and had nominally significant differences in lung function and asthma control compared to omalizumab.
In this study, the safety profile of dupilumab was generally consistent to its known safety profile in its approved respiratory indications and there were similar overall rates of adverse events between dupilumab and omalizumab.
Q. How will these findings impact clinical practice?
These findings demonstrate how dupilumab and omalizumab compare to each other in patients who suffer from a higher disease burden because of their coexisting diseases. The insights from this study can help guide patients and physicians through the treatment decision-making process.
Further content in rhinosinusitis and asthma.
This content has been developed independently by Touch Medical Media for touchRESPIRATORY. It is not affiliated with the European Academy of Allergy and Clinical Immunology (EAACI). Views expressed are the speaker’s own and do not necessarily reflect the views of Touch Medical Media.
Editor: Victoria Smith, Senior Content Editor.
Cite: Eugenio De Corso. EVEREST Trial Reveals Dupilumab’s Superiority Over Omalizumab in CRSwNP with Asthma. touchRESPIRATORY. 30 June 2025.
Disclosures: This short article was prepared by touchRESPIRATORY in collaboration with Eugenio De Corso. touchRESPIRATORY utilize AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No fees or funding were associated with its publication.
Eugenio De Corso discloses serving on advisory boards for Sanofi, GSK, and Astrazeneca; and participating in speaker’s bureaus with Sanofi, GSK, and Astrazeneca.
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