What clinical remission definition do experts suggest for severe asthma?
Clinical remission is a treatment goal for severe asthma that goes beyond just managing symptoms. Experts propose a definition that includes four key components: no asthma exacerbations (flare-ups), no use of oral corticosteroids, good symptom control, and stable or optimal lung function. This definition helps doctors and patients aim for the best possible outcomes with biologic therapies.
What the research says
A panel of Asia-Pacific experts reviewed the literature and proposed that clinical remission in severe asthma should include elimination of exacerbations and oral corticosteroid use, good symptom control, and inclusion of lung function criteria 4. They noted that while restoring normal lung function may be unrealistic for most patients, striving for optimal individual lung function or maintaining stability is important 4.
Data from the UK Severe Asthma Registry (UKSAR) applied a similar definition: Asthma Control Questionnaire (ACQ)-5 score less than 1.5, no oral corticosteroids for disease control, and forced expiratory volume in 1 second (FEV1) above the lower limit of normal or no more than 100 mL less than baseline 6. Using this definition, 18.3% of patients achieved clinical remission on biologic therapy 6.
A comparative review of biologic therapies for severe asthma and chronic rhinosinusitis with nasal polyps proposed a 'dual clinical remission' definition that combines zero exacerbations and no oral corticosteroids with clinically meaningful sinonasal improvement 7. This highlights the importance of considering both airway and sinus disease in remission goals.
Overall, experts agree that clinical remission is a composite outcome that includes exacerbation control, symptom control, lung function stability, and reduced need for oral corticosteroids 467.
What to ask your doctor
- What does clinical remission mean for my severe asthma, and how is it measured?
- What are my current asthma control scores (like ACQ or ACT) and lung function (FEV1)?
- Could I aim for remission with my current biologic therapy, or should we consider switching?
- How do my sinus symptoms (if any) factor into remission goals?
- What steps can we take to reduce or eliminate my need for oral corticosteroids?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.