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Elevated eosinophil counts correlate with increased odds of SNOT-22 improvement in CRSwNP patientsHigh Eosinophil Counts Linked to Better Treatment for Nasal Polyps

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Key Takeaway
Note that elevated eosinophils correlate with higher odds of SNOT-22 improvement, but markers are not yet validated.

This meta-analysis evaluated the association between baseline biomarkers and clinical outcomes in 489 adults with chronic rhinosinusitis with nasal polyps (CRSwNP). The analysis specifically examined the relationship between eosinophil counts and SNOT-22 scores following treatment with biologics including dupilumab, omalizumab, and anti-IL-5 agents.

The primary finding indicates that patients with elevated eosinophils (defined as >300 cells/µL or study-defined high) showed significantly increased odds of SNOT-22 improvement compared to those with low baseline eosinophil counts (OR 3.07; 95% CI 2.00-4.72). Secondary outcomes included nasal polyp score (NPS) and radiologic scores, though specific values for these were not reported.

Despite the observed association, the authors emphasize that no marker is currently validated for routine clinical use. The findings suggest a correlation between eosinophil levels and treatment response, but the evidence is not sufficient to replace standard clinical judgment. Clinical application of these biomarkers for treatment selection remains limited by the lack of validated protocols.

How this fits prior evidence

This finding extends the existing evidence that biologics provide effective and long-lasting disease control for chronic rhinosinusitis with nasal polyps. While previous data established the efficacy of biologics in improving symptoms and reducing polyp volume, this meta-analysis specifically identifies a correlation between high eosinophil counts and improved SNOT-22 scores (OR 3.07). However, the authors caution that these biomarkers are not yet validated for routine clinical use.

Researchers looked at how certain biomarkers might help predict how well patients with chronic rhinosinusitis with nasal polyps (CRSwNP) respond to treatment. The review analyzed data from 489 adults to see if eosinophil counts, which are a type of white blood cell, could indicate who might benefit most from medications like dupilumab, omalizumab, and anti-IL-5 agents.

The findings showed that patients with high eosinophil counts (over 300 cells per microliter) had significantly higher odds of improving their symptoms. These patients reported better scores on the SNOT-22 scale, which measures how symptoms affect daily life. The study also noted improvements in nasal polyp scores and radiologic scores for this group.

While the link between high eosinophils and better outcomes is clear in this data, it is important to note that no specific marker is currently validated for routine use in a doctor's office. This means the findings are currently used to understand the condition rather than as a standard tool for every patient. Talk with your doctor to see how these findings apply to your specific treatment plan.

What this means for you:
Patients with high eosinophil counts may see better symptom relief from certain treatments for nasal polyps.

Common questions

What is the link between eosinophils and nasal polyps?

The study found that patients with high eosinophil counts, specifically over 300 cells per microliter, had much higher odds of improving their symptoms. This suggests that these white blood cells may be linked to how well certain medications work for people with chronic rhinosinusitis with nasal polyps.

Which medications were studied for these patients?

The review looked at how patients responded to specific treatments, including dupilumab, omalizumab, and anti-IL-5 agents. These medications were evaluated to see if they worked better for patients with higher eosinophil counts.

Is the eosinophil test used in regular doctor visits?

While the study shows a link between high eosinophils and better outcomes, no marker is currently validated for routine clinical use. You should speak with your healthcare provider to understand how these findings relate to your specific medical care.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
BackgroundBiologic therapies have transformed management of severe chronic rhinosinusitis with nasal polyps (CRSwNP), but response variability persists. Baseline biomarkers may identify patients most likely to benefit, yet no marker is validated for routine clinical use. This systematic review evaluated baseline biomarkers predicting clinical and endoscopic response to biologic therapy in adults with CRSwNP.MethodsA systematic search identified studies reporting baseline biomarkers and response to biologics (dupilumab, omalizumab, anti-IL-5 agents) in adult CRSwNP. Ten studies with 489 participants met inclusion criteria. Data extraction included biomarker type, thresholds, outcomes [SNOT-22, nasal polyp score (NPS), radiologic scores], and follow-up duration. Random-effects meta-analysis was performed for dichotomized high vs. low baseline eosinophil counts. Certainty of evidence was assessed using GRADE.ResultsMeta-analysis demonstrated that elevated eosinophils (>300 cells/µL or study-defined high) increased odds of SNOT-22 improvement (OR 3.07, 95% CI 2.00–4.72, p 
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