On-treatment clinical remission of severe asthma with real-world longer-term biologic use

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BackgroundThere are limited real-world data describing the proportion of patients with severe asthma (SA) who achieve on-treatment clinical remission with long-term biologic treatment. ObjectiveTo examine the proportion and characteristics of adults with SA who achieved clinical remission with biologic therapy. MethodsCHRONICLE is an observational study of US subspecialist-treated adults with SA. Sites reported exacerbations and biologic use from 12 months prior to enrollment forward. Monthly Asthma Control Test (ACT) scores and 6-monthly specialist assessments of asthma control were collected. Patients enrolled from February 2018–February 2023 with biologic initiation during the study observation period and continued use for ≥12 months were evaluated. Incident on-treatment clinical remission was defined in a 12-month interval as the absence of exacerbations and systemic corticosteroid (SCS) use, ≥50% of ACT scores ≥20 in the latest 6 months, and specialist report of asthma control. ResultsAmong evaluable patients (N=611), median duration of biologic use was 39.6 months. In at least one 12-month interval during the study, 79.9% of patients had no exacerbations or SCS use, and 46.0% met the definition of clinical remission at any point. The point prevalence of clinical remission increased from 22.3% at 12–13 months of biologic use to 34.3% at 47–48 months of biologic use. ConclusionsIn a real-world cohort of patients with SA with longer-term biologic treatment, almost one-half achieved on-treatment clinical remission. With a year or more of biologic therapy, clinical remission is a feasible treatment goal in SA.