Long-Term Clinical Remission on Biologics: An Analysis of Real-World Data From the UK Severe Asthma Registry.

Abstract

Background: Clinical remission on biologics is an achievable goal for patients with severe asthma (SA). Most reports present short-term follow-up, include small cohort sizes, or present data on patients included in clinical trials. Objective(s): This study evaluates clinical remission rates in a real-world cohort of patients over the course of up to 4 years on different biologics and include those who switched biologic during this period. We also assess barriers and predictors of remission. Method(s): Retrospective study of 525 patients in the U.K. SA registry who were initiated on a biologic between January 2015 and May 2022. Clinical remission was assessed at 2 time points: first review (9-24 mo) and long-term review (30-48 mo), and defined as controlled asthma (Asthma Control Questionnaire [6-item] < 1.5), no exacerbations in the preceding 12 months, and no maintenance oral corticosteroid use. Result(s): Clinical remission was achieved in 25.1% at first review, increasing to 32.1% at long-term review. This improvement occurred regardless of biologic switching. Among those in remission at first review, 69.7% remained in remission at long-term review whereas 45.6% of those in long-term remission had not been in remission at first review. Higher symptoms burden and presence of anxiety/depression was negatively associated with achieving long-term remission. Advanced age at baseline and the presence of nasal polyps increased the likelihood of long-term remission. Conclusion(s): In this large real-world cohort of patients with SA, there is a progressive increase in remission rates over 4 years, which is influenced by the presence of comorbidities but is largely independent of biologic switching. Copyright © 2025 American Academy of Allergy, Asthma & Immunology