Identification of predictive factors for clinical remission and comparison of 3 definitions in Japanese patients with severe asthma treated with biologics.

Background: The definition and predictive factors of clinical remission (CR) in patients with severe asthma are unclear. Objective: We sought to elucidate the remission rate among patients and predictive factors and concordance rates of CR among 3 definitions. Methods: From July 2009 to November 2024 at Jikei University Hospital, 126 patients who received treatment with biologics for ≥ 12 months were evaluated retrospectively. Results: Biologics was given to 40 men and 86 women for ≥ 12 months. Initially, 34, 42, 27, 21, and 2 patients received omalizumab, mepolizumab, benralizumab, dupilumab, and tezepelumab, respectively. After treatment, among all patients, the following criteria were achieved: asthma control test score of ≥ 23 in 32% of patients, no exacerbations in 62%, no oral corticosteroid maintenance use in 72%, and pulmonary function optimization in 94%. The percentage of patients with CR according to the 2 Japanese definitions, 1 with 3 criteria excluding pulmonary function and 1 with 4 criteria including pulmonary function, was 25% and 24%, respectively. The percentage of patients who met the other definition of CR with 4 criteria, ie, an asthma control test score ≥ 20, no oral corticosteroid use, no exacerbations, and %FEV Conclusions: The 2 Japanese definitions, with 3 and 4 criteria, respectively, were highly concordant.