Self-directed de-escalation of maintenance inhaler therapy in patients with severe asthma in remission with biologic treatment: An observational study

Background: mAbs targeting type 2 inflammation have significantly improved disease control in severe asthma. As more patients achieve clinical stability, the safety and outcomes of maintenance inhaled therapy (MIT) de-escalation have become clinically relevant. Although guidelines support personalized treatment and cautious MIT reduction in patients whose severe asthma is well controlled, the real-world evidence remains limited. Objectives: Our aim was to evaluate whether clinical stability can be maintained following the voluntary de-escalation of MIT by patients with severe eosinophilic asthma who are undergoing treatment with biologics. Methods: value), exacerbations, and clinical remission status were collected at baseline (T0), 12 months (T1), and 24 months (T2). Results: precent predicted values. Conclusion: MIT de-escalation in patients with severe asthma treated with a biologic appears feasible and safe. These data support consideration of MIT de-escalation as an additional component of complete clinical remission.