Current data on biologics: Evaluating clinical remission in asthma

Area of Science:

• Pulmonology
• Immunology
• Clinical Therapeutics

Background:

• Biologic therapies show promise for severe asthma, leading to interest in clinical remission.
• Observed remission rates in adults with severe asthma treated with biologics range from 13% to 43% across studies.
• Current remission definitions often include exacerbations, oral corticosteroid use, symptom control, and lung function.

Purpose of the Study:

• To review the current understanding of clinical asthma remission in patients receiving biologic therapy.
• To highlight the need for prospective studies to refine remission definitions and identify associated patient characteristics.
• To explore the current state of knowledge regarding asthma remission in pediatric populations.

Main Methods:

• Review of retrospective real-world studies and post hoc analyses of randomized controlled trials.
• Analysis of remission criteria, focusing on a common 4-component definition.
• Synthesis of evidence regarding patient factors associated with achieving remission.

Main Results:

• Adult asthma remission rates with biologics vary (19-43% real-world, 13-35% RCTs).
• Type 2 inflammatory endotype, less severe disease, shorter duration, and fewer comorbidities predict remission.
• Limited data exists on asthma remission in children and adolescents on biologics.

Conclusions:

• Biologic therapy can induce substantial and durable improvements in severe asthma, with notable remission rates.
• Further prospective research is essential to standardize asthma remission criteria and identify key predictors.
• Understanding remission in pediatric asthma patients requires dedicated investigation.