Real-world assessment of clinical remission in asthma with biologics

<bold>Background:</bold> Clinical Remission (CR) in severe asthma patients treated with biologics, encompassing a broad range of criteria as defined by ATS/ACAAI/AAAAI, provides an ambitious treatment goal but its real-world application remains poorly understood. <bold>Aims and Objectives:</bold> This study evaluates the extent to which components of CR measure are documented and achieved in asthma patients initiated on respiratory biologics in the US. <bold>Methods:</bold> A retrospective cohort study was conducted using the Mayo Clinic's EHR database, analysing adult asthma patients (≥18 years) treated with respiratory biologics from January 2015 to March 2022. The study focused on the documentation and evaluation of 7 CR criteria: asthma exacerbations, systemic corticosteroid use, controller and rescue medication use, ≥2 asthma control tests, ≥2 pulmonary function tests, and missed work or school due to asthma. <bold>Results:</bold> Among 707 respiratory biologics initiators (average age 52.1 years, 61.0% female), 94.2% had documentation for at least one CR criterion. However, no patients had documentation for all 7 criteria. Among patients with available data, 91.2% met at least 1 criterion, 65.5% met 2+, 28.3% met 3+ and only 6.2% met 4+ criteria in the broader respiratory biologic cohort. In contrast, in the mepolizumab cohort (n=141), more patients met at least one criterion (98.6%), 2+ (82.3%), 3+ (44.7%) and 4+ (9.9%) criteria. <bold>Conclusions:</bold> This study highlights a significant gap in documentation of CR endpoints in routine clinical practice, suggesting a need for standardised protocol. Mepolizumab demonstrated a higher likelihood of meeting multiple CR criteria compared with overall respiratory biologic cohort. Funding: GSK (219744)