Defining Clinical Remission in Severe Asthma: Expert Opinion From the Gulf Region Using the Modified Delphi Method

Area of Science:

• Pulmonology and Immunology
• Asthma Research
• Clinical Trial Design

Background:

• Biologics and patient-centricity are changing asthma management.
• Revised clinical goals require a clear definition of asthma remission.
• Understanding asthma phenotypes, endotypes, and pathophysiology is essential.

Purpose of the Study:

• To establish comprehensive criteria for clinical remission in severe asthma.
• To gather expert consensus on defining remission in the context of current asthma treatments.
• To provide an operational definition for clinical remission in severe asthma.

Main Methods:

• Systematic gathering and analysis of expert insights from pulmonology and immunology specialists in the Gulf Countries.
• Utilized a pre-workshop survey, a scientific workshop, and two rounds of Delphi surveys.
• Developed expert opinion on criteria for 'on-treatment' remission.

Main Results:

• Agreed-upon comprehensive criteria for defining clinical remission in severe asthma.
• Key criteria for remission include sustained absence of asthma symptoms and exacerbations.
• Stable lung function and absence of systemic corticosteroids for at least 12 months are also defining factors.

Conclusions:

• The study provides a consensus-based definition for clinical remission in severe asthma.
• These criteria are vital for guiding treatment goals and assessing outcomes in the era of biologics.
• The established criteria offer a framework for future asthma management strategies.