Jason Moraczewski, Leonard B Bacharier
The principles underlying asthma management are evolving from a reactive model focused on symptom relief and exacerbation management to a proactive approach to achieve full disease control, with consideration of on-treatment clinical remission and disease modification. The advent of biologic therapies targeting type 2 inflammation, and to an extent allergen immunotherapy, have shown promise in achieving a state of on-treatment remission. Emerging evidence suggests that biologics have the potential to induce remission and structural disease modification, but further studies are needed to assess these outcomes as the primary endpoint. To more accurately assess remission as a meaningful outcome in asthma, definitions need to be standardized and validated across studies with special consideration to incorporate biomarker changes and applicability to diverse populations, including children. Ultimately, the transition toward remission- or disease modification-based care may represent a new frontier in the care of asthma.