What are the lung function goals for patients with severe asthma?
For severe asthma, lung function goals are part of a broader treatment target called clinical remission. Because airways can become permanently remodeled, doctors aim for each patient's best possible lung function (often measured as FEV1) and keeping it stable over time, rather than trying to reach normal values. This approach is recommended by Asia-Pacific experts and aligns with general asthma treatment principles.
What the research says
A 2024 Asia-Pacific expert panel proposed that clinical remission in severe asthma should include lung function criteria, specifically striving for optimal individual lung function or maintaining stability, since restoring normal lung function may be unrealistic for most patients with remodeled airways 4. This goal is consistent with general asthma treatment principles that emphasize preventing accelerated loss of pulmonary function (FEV1) and maintaining normal activity levels 6.
Biologic therapies can improve lung function in severe asthma. A systematic review of switching biologics found a mean increase in FEV1 of 0.18 liters after switching, with low variability across studies 1. However, a retrospective study noted that biologic effects on lung function are variable, and baseline inflammation patterns (eosinophilic, neutrophilic, mixed) may influence outcomes 3.
Patient-selected goals often differ from clinician goals. In one study, only 53% of patient goals aligned with clinician treatment goals, and patients who chose disease-specific goals (like improving lung function) were more likely to achieve both control and their goal 8. This highlights the importance of discussing lung function targets with your doctor.
What to ask your doctor
- What is my current FEV1 and what would be a realistic personal goal for me?
- How often should I have lung function tests to track stability?
- Could a biologic therapy help improve or preserve my lung function?
- How do my lung function goals fit into the overall plan for clinical remission?
- What can I do to prevent further loss of lung function?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.