Introduction

Clinical remission in severe asthma has been poorly studied and remains to be defined.

Aims and Objectives

We explored factors associated with different definitions of asthma remission at ~1-year post-biologic initiation.

Methods

Using data from the International Severe Asthma Registry (ISAR) in 1347 patients who initiated their first biologics, we a priori defined four composite definitions of remission: 1) no exacerbation and no long-term oral corticosteroid (LTOCS) use; 2) plus partly/well controlled asthma; 3) or percent predicted FEV1 ?80%; and 4) all criteria combined. We examined the association between different definitions of remission and selected patient?s characteristics (Figure 1) using logistic regressions.

Results

Fewer exacerbations, lower LTOCS use, better symptom control, and better lung function prior to biologic initiation were positively associated with remission, regardless of the definition applied. Odds of remission were also higher in patients with lower body mass index, shorter asthma duration, and T2-related comorbidities (Figure 1). For example, a 10-year increment in asthma duration was associated with a 19% reduction (p=.015) of remission odds (all criteria combined).

Conclusions

Initiating biologics earlier in the disease history, before the development of severe impairments, is associated with an increased likelihood of clinical remission following biologic initiation.