Background

Recently, criteria for evaluation of response to biologics have been proposed and the concept of clinical remission has gained attention as possible goal even in severe asthma.

Aim

To analyse the response and remission in the GAN severe asthma cohort.

Methods

We included 443 adults not using a biologic at baseline (V0) and compared patients treated between V0 and 1-year-visit (V1) without using a biologic (group A) with patients starting with a biologic after V0 and continuing it up to V1 (group B). We applied the Biologics Asthma Response Score (BARS) to quantify composite response in good, intermediate or insufficient. We defined clinical remission (R) as good symptom control (ACT?20) at V1 in the absence of exacerbations and OCS therapy.

Results

In group B, patients received omalizumab (15.7%), mepolizumab (19.0%), benralizumab (38.5%), reslizumab (0.4%) or dupilumab (26.6%). Comparing baseline parameters, group B (210 patients) had less often an allergic phenotype (35.2% vs 41.6%), lower asthma control test (ACT) values (median 12 vs 14), more exacerbations in the past year (median: 3 vs 2), and more often high-dose ICS treatment (71.4% vs 51.5%) than group A (233 patients). After 1 year of treatment, rates of good response (61.4% vs. 34.8%) and/or clinical remission (37.6% vs. 17.2%) were significantly higher in group B than in group A.

Conclusion

Despite suffering from more severe asthma at baseline, patients treated with biologics had a markedly higher probability of achieving good clinical response and/or remission than patients treated without biologics.