• Luis Perez-de-Llano, Ghislaine Scelo, Trung N Tran, Tham T Le, Malin Fagerås, Borja G Cosio, Matthew Peters, Paul E Pfeffer, Mona Al-Ahmad, Riyad O Al-Lehebi, Alan Altraja, Celine Bergeron, Leif H Bjermer, Anne S Bjerrum, Lakmini Bulathsinhala, John Busby, Diana J Cano Rosales, Giorgio W Canonica, Victoria A Carter, Jeremy Charriot, George C Christoff, Eve J Denton, Delbert R Dorscheid, Maria J Fernandez Sanchez, João A Fonseca, Peter G Gibson, Celine Y Y Goh, Liam G Heaney, Enrico Heffler, Mark Hew, Takashi Iwanaga, Rohit Katial, Mariko S Koh, Piotr Kuna, Désirée E S Larenas-Linnemann, Lauri Lehtimäki, Bassam Mahboub, Neil Martin, Hisako Matsumoto, Andrew N Menzies-Gow, Nikolaos G Papadopoulos, Todor A Popov, Celeste M Porsbjerg, Pujan Patel, Chin K Rhee, Mohsen Sadatsafavi, Camille Taillé, Carlos A Torres-Duque, Ming-Ju Tsai, Charlotte S Ulrik, John W Upham, Anna von Bülow, Eileen Wang, Michael E Wechsler, and David B Price.
• Pneumology Service, Lucus Augusti University Hospital, EOXI Lugo, Monforte, Cervo, Spain.
• Am. J. Respir. Crit. Care Med. 2024 Oct 1; 210 (7): 869880869-880.

AbstractRationale: There is no consensus on criteria to include in an asthma remission definition in real life. Factors associated with achieving remission after biologic initiation remain poorly understood. Objectives: To quantify the proportion of adults with severe asthma achieving multidomain-defined remission after biologic initiation and identify prebiologic characteristics associated with achieving remission that may be used to predict it. Methods: This was a longitudinal cohort study using data from 23 countries from the International Severe Asthma Registry. Four asthma outcome domains were assessed in the 1 year before and after biologic initiation. A priori-defined remission cutoffs were: 0 exacerbations/yr, no long-term oral corticosteroid (LTOCS), partly/well-controlled asthma, and percent predicted FEV1 ⩾ 80%. Remission was defined using two (exacerbations + LTOCS), three (+control or +lung function), and four of these domains. The association between prebiologic characteristics and postbiologic remission was assessed by multivariable analysis. Measurements and Main Results: A total of 50.2%, 33.5%, 25.8%, and 20.3% of patients met criteria for two-, three- (+control), three- (+lung function), and four-domain remission, respectively. The odds of achieving four-domain remission decreased by 15% for every additional 10 years of asthma duration (odds ratio, 0.85; 95% confidence interval, 0.73-1.00). The odds of remission increased in those with fewer exacerbations per year, lower LTOCS daily dose, better control, and better lung function before biologic initiation. Conclusions: One in five patients achieved four-domain remission within 1 year of biologic initiation. Patients with less severe impairment and shorter asthma duration at initiation had a greater chance of achieving remission after biologic treatment, indicating that biologic treatment should not be delayed if remission is the goal.

24 keywords...

hide…