Is it possible to go from control to super responder to remission in asthma?

Abstract

Background: Asthma, a chronic airway inflammatory disease, traditionally focuses on symptom control and minimizing complications as per asthma guidelines. Recently, the concept of achieving clinical remission has emerged as a more ambitious treatment goal. Objective: This review explores clinical remission (on and off treatment), super-responders, and complete remission (on and off treatment) in asthma. It also examines the potential of biologics in achieving clinical remission for severe asthma. Methods: A literature review on clinical remission, super-responders, and complete remission in asthma, along with biologics and remission was conducted. Results: Leading allergist/pulmonologist groups and professional societies worldwide have proposed criteria for clinical remission. Whereas core elements such as no systemic corticosteroids, no exacerbations, and stable and/or improved lung function for at least a year are generally agreed on, specific details remain under debate. U.S. guidelines incorporate stricter criteria for clinical remission. In addition, the term “super-responder” describes patients with severe asthma and with major quality-of-life improvements after receiving biologics. Despite limited studies, biologics seem to produce remission rates (20‐40%), depending on the criteria used. Conclusion: A universally accepted definition for clinical remission in asthma remains under development. The concept of super-responder requires further investigation in research and clinical settings. Whereas early studies show promise, biologic therapies, although revolutionary for severe asthma treatment, do not guarantee clinical remission for most patients.