Benralizumab-Induced Asthma Remission: Impact of Different Tools and Thresholds to Define Good Asthma Control

Current definitions of clinical remission (CR) use different tools and thresholds to define good asthma control. Their differential impact on CR rates in severe asthma is poorly understood.

Data from a real-world study in patients with SEA treated with benralizumab (imPROve Asthma, NCT04184284, total number of patients: 244 patients) were analyzed. Four-component CR (4-CR) was defined as no exacerbations, no systemic steroid treatment, stable or normal lung function, and good asthma control, for at least 12 months. The impact of 2 different asthma control measures (Asthma Control Questionnaire [ACQ] and Asthma Control Test [ACT]) with varying thresholds for good asthma control (ACQ: ≤1.5 or ≤0.75, ACT: ≥20 or ≥23) on CR rates was examined.

Complete data on all remission criteria were available for 131 patients after 12 months of follow-up, and 85 patients after 24 months of follow-up. After 12 months, 4-CR criteria were fulfilled in 42.7% (ACQ-6 ≤1.5), 36.9% (ACT ≥20), 24.4% (ACQ-6 ≤0.75), and 21.5% (ACT ≥23) of the patients. After 24 months, 4-CR criteria were fulfilled in 39.2% (ACQ-6 ≤1.5), 31.8% (ACT ≥20), 22.8% (ACQ-6 ≤0.75), and 17.6% (ACT ≥23) of the patients.

CR is achievable in a substantial proportion of patients with SEA treated with benralizumab in a real-world setting. CR rates are strongly dependent on definitions of asthma control, with almost twice as high CR rates found using the ACQ-6 ≤1.5 criterion as compared with the ACT ≥23 criterion.