Asthma remission : how much can we improve?

Asthma continues to be a challenging disease and despite new therapies there is still no cure, however the concept of remission has increasingly been set out as a goal. We carried out a retrospective analysis of the last 5 years of patients with asthma under biological therapy at the Portimão hospital, in order to identify patients with clinical remission criteria. The definition of the criteria was based on previous studies, considering: control of symptoms through a score greater than or equal to 24 on the CARAT questionnaire, absence of exacerbations in the last year and improvement in FEV1 after biological therapy or in cases without previous values from FEV1 to maintenance of values >80%. During this period, 53 patients underwent biological therapy, 2 were excluded due to an adverse reaction. 15.6% met remission criteria. This group had a similar distribution to the rest of the population, with a predominance of females (75%), an average age of 54.5 years and the majority with the onset of asthma in adulthood. 87.5% had rhinitis and >50% had nasal polyposis. Of the patients in remission, 50% had already taken a previous biologic (the most common being omalizumab). Among the patients that have not attained the criteria for remission, 30.2% had started therapy less than a year ago, with a large proportion of them being symptomatically controlled but without enough time to define remission. Another explanation found for the lack of remission in a greater number of patients could be the advanced age at the beginning of therapy and the presence of comorbidities. With this study we intend to understand the Portuguese reality in terms of remission in order to provide more robust information for the definition of clinical remission criteria.