[Correspondence] EVEREST and the eosinophil paradox – Authors' reply

We thank Jingyuan Ning and colleagues for their comments and agree with their assessment of the Evaluating Treatment Responses of Dupilumab vs Omalizumab in patients with type 2 inflammatory disease (EVEREST) trial results and the importance of dupilumab's comprehensive inhibition of type 2 inflammatory pathways.1 Although blood eosinophils were transiently elevated in the dupilumab group, we did not observe a correlation between baseline eosinophil levels and nasal polyp outcomes. Transient elevations in blood eosinophils have previously been observed in dupilumab studies for asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), consistent with the intrinsic pharmacodynamic mechanism of the drug.