Remission on biologics for severe asthma - 5 years of follow-up

<bold>Background:</bold> Clinical remission is a novel treatment goal in severe asthma. Most studies examine remission after one year. With this study we examined clinical remission during a five-year follow-up. <bold>Methods:</bold> We performed a retrospective study from a single severe asthma outpatient clinic using electronic patient files. Data on remission were collected after 1, 2, and 5 years of biological treatment. Patients included in this study initiated anti-IL5/anti-IL5R treatment between June 2016 and January 2018 and were followed for 5 years. Switching between biologics was allowed. Core components in the remission definition were; 1) no oral corticosteroid (OCS) daily or for treating exacerbations within the last year, 2) asthma control defined as ACQ < 1,5/ ACT > 19, 3) normal lung function defined as FEV1 in percent of predicted =/> 80%. <bold>Results:</bold> 78 patients initiated anti-IL5/IL5 R treatment in the period. 10 patients stopped treatment or were lost to follow up during the 5-year period. Before initiating biologic treatment, 78% of patients were on daily OCS. Remission, defined as no OCS was achieved by 32%, 42% and 74% of patients after 1, 2, and 5 years. Remission, defined as no OCS plus normal lung function was achieved by 10%, 22% and 24% of patients after 1, 2, and 5 years. Remission, defined as no OCS plus asthma control, was achieved by 18%, 25% and 47% of patients after 1, 2, and 5 years. Remission for all three components were achieved for 8%, 11% and 17% of patients after 1, 2, and 5 years. <bold>Conclusion:</bold> The number of patients achieving remission increased over time for 1, 2, and 3 component remission. The three component remission was difficult to achieve and the low lung-function seemed to impact the results the most