Dupilumab versus omalizumab in chronic rhinosinusitis with nasal polyps and asthma: a plain language summary

Plain Language SummaryWhat is this summary about?People with chronic rhinosinusitis with nasal polyps (CRSwNP) have symptoms like a stuffy and runny nose, difficulty breathing through their nose, and loss of sense of smell. This negatively affects their quality of life.People with asthma have symptoms in their lower airways like coughing, wheezing, shortness of breath, and tightness in the chest.Around two out of every three people with CRSwNP also have asthma and are more likely to have severe nasal symptoms.Dupilumab and omalizumab are two medicines that are approved for treatment of CRSwNP and asthma.Severe CRSwNP is when the symptoms do not get better with nasal steroids or other treatments.EVEREST was a clinical study that assessed how well dupilumab works compared with omalizumab to improve symptoms for people with severe CRSwNP and asthma.What were the main results of the EVEREST study?Six months of dupilumab treatment improved people’s sense of smell, nasal congestion, and overall symptoms more than omalizumab.The nasal polyps of people who took dupilumab shrank more than in people who took omalizumab.Dupilumab improved lung function and quality of life more than omalizumab.What do the results of the EVEREST study mean?In patients with severe CRSwNP and coexisting asthma, dupilumab improved symptoms and other measures of CRSwNP (in the upper airways) over 6 months compared with omalizumab.Additional findings suggested that dupilumab could potentially improve asthma symptoms (lower airways) in a population with CRSwNP and asthma compared with omalizumab.This supports the practice that the nose, sinuses, and lungs should be treated together as part of one airway system.Similar numbers of patients had side effects with each medicine.This is the first time that dupilumab and omalizumab have been directly compared in a clinical study of people who have both CRSwNP and asthma.Clinical trial number: NCT04998604 (Phase 4 EVEREST study)