An expert consensus framework for asthma remission as a treatment goal

Area of Science:

• Pulmonology
• Immunology
• Clinical Medicine

Background:

• Novel asthma therapies are emerging, shifting focus towards remission as a treatment objective.
• Existing definitions of asthma remission are limited, necessitating a standardized framework.

Purpose of the Study:

• To develop a generalized framework for defining asthma remission, encompassing both clinical and complete remission states.
• To establish criteria for asthma remission both on and off asthma treatment.

Main Methods:

• A modified Delphi survey approach was employed to achieve expert consensus on asthma remission components.
• Literature review identified remission definitions in other chronic inflammatory diseases and spontaneous asthma remission.

Main Results:

• Clinical remission defined as ≥12 months with symptom absence, optimized lung function, patient/provider agreement, and no systemic corticosteroids.
• Complete remission includes clinical remission plus objective resolution of inflammation and potentially negative bronchial hyperresponsiveness.
• Remission off treatment requires no asthma treatment for ≥12 months.

Conclusions:

• The proposed framework provides a foundational definition for asthma remission as a therapeutic target.
• Further research, patient input, and clinical studies are needed to refine and validate this remission framework.