The following is a summary of “Barriers to clinical remission in severe asthma,” published in the April 2024 issue of Pulmonology by Farinha et al.
Severe asthma presents a significant challenge, marked by heightened exacerbation risk, diminished lung function, fixed airflow obstruction, and substantial morbidity and mortality. As monoclonal antibody therapies increasingly target specific inflammation pathways, the notion of achieving remission in severe asthma has garnered attention as a treatment goal.
This review explores current remission definitions and identifies barriers to attaining this state in patients with severe asthma. While a unified definition remains elusive, clinical remission in asthma typically entails sustained symptom control, cessation of oral corticosteroid use and exacerbations, and stabilization of lung function. Yet, achieving these criteria proves realistic for only a minority of patients. Several unmet needs in severe asthma hinder remission. Delayed intervention with targeted therapies may heighten corticosteroid exposure risk and irreversible airway changes.
Airway infections pose a persistent challenge, especially in patients on biologic therapies. Phenotyping exacerbations can aid therapy decisions and curb oral corticosteroid use. Additionally, the intricate interplay between asthma and comorbidities complicates remission goals. Evaluating behavioral factors alongside optimized treatment and leveraging biomarkers to target treatable traits may offer a more objective approach to remission. International consensus on remission criteria is essential, warranting inclusion in future management guidelines.
Source: respiratory-research.biomedcentral.com/articles/10.1186/s12931-024-02812-3
