Clinical response and remission in patients with severe asthma treated with biologic treatment: Findings from the nationwide Danish Severe Asthma Registry

Abstract

<b>Background:</b> There is growing interest in the ability of biologic treatment to induce remission of severe asthma, and clinical remission on treatment has recently been defined as complete control of exacerbations, oral corticosteroid (OCS) use, lung function and asthma symptoms. We assessed response rates and baseline characteristics associated with these outcomes in a real-life setting. <b>Methods:</b> The Danish Severe Asthma Registry is a nationwide register including all patients receiving biologic treatment for severe asthma in Denmark. We defined “clinical response” to treatment after 12 months as ≥50% reduction in exacerbations, and/or a ≥50% reduction in OCS dose. “Clinical remission on treatment” was defined by cessation of exacerbations and maintenance OCS, as well as a normalization of lung function (FEV1%&gt;80%) and an Asthma Control Questionnaire score ≤1.50. <b>Results:</b> In 274 bio naïve patients, 225 (82%) had a clinical response, of whom 43 (19%) fulfilled our criteria of clinical remission, whereas 49 (18%) patients were non-responders. Compared to patients who obtained a clinical response, patients with clinical remission were more likely to be male (71% vs. 48%), have disease duration less than 10 years (47% vs. 29%), have higher baseline blood eosinophils (0.48 vs. 0.32 x109/L) and higher IgE levels (231 vs. 136 kUA/L). <b>Conclusion:</b> A majority of patients obtained a clinically significant response. Clinical remission was predicted by shorter disease duration, and higher levels of T2 biomarkers; further studies are required to assess whether timing of biological treatment is crucial for better long-term outcomes.