Abstract Rationale The advent of monoclonal antibody therapy to treat asthma has made full clinical remission a feasible treatment goal. However, patient factors associated with achieving remission among adults in observational settings are needed to inform clinical expectations, guide patient counseling, and identify individuals who may benefit from additional monitoring or additional interventions. Here we aim to identify patient-level factors associated with clinical remission among patients who initiated monoclonal antibody therapy for asthma. Methods We conducted a retrospective cohort study of 1,465 patients with asthma at Penn Medicine who initiated monoclonal antibody therapy between 1/1/2017 and 05/15/2025. We included 465 patients (31.7%) with at least 9 months of documented follow-up. Clinical remission at 12 months was defined as: 1) no asthma exacerbations, 2) no oral corticosteroid use, and 3) ≤2 short-acting beta-agonist prescriptions. We evaluated demographic (age, sex, race), clinical (BMI, smoking), and socioeconomic (insurance) factors using univariable and multivariable logistic regression. Models included all 465 patients (demographics/socioeconomic factors) and a subset of 310 patients (66.7%) with baseline exacerbation data to assess disease severity associations. Results At 12 months, 157 of 465 patients (33.8%; 95% CI: 29.5-38.3%) achieved 3-component clinical remission. Remission rates varied by baseline exacerbation burden (0 exacerbations: 44.9%; 1-2 exacerbations: 29.0%; ≥3 exacerbations: 17.9%) and age group (40 years: 23.8%; 40-59 years: 32.7%; ≥60 years: 44.1%). In univariable analyses, older age (OR 1.03 per year, p 0.001), public or other insurance versus commercial (Medicare OR 3.52, p = 0.001; Other OR 3.09, p = 0.003), and lower baseline disease burden (baseline exacerbations OR 0.89 per event, p = 0.001; severe exacerbations OR 0.31, p = 0.01) were associated with remission. In the multivariable model restricted to patients with baseline severity data (n = 310), older age (adjusted OR aOR 1.03 per year, 95% CI: 1.01-1.05, p = 0.005) and fewer baseline exacerbations (aOR 0.91 per event, 95% CI: 0.83-0.98, p = 0.02) remained independently associated with remission after adjustment for sex, race, insurance, and body mass index. CONCLUSIONS Older age and lower baseline exacerbation burden were independently associated with remission, suggesting these factors may identify patients most likely to achieve optimal disease control. Younger patients and those with frequent baseline exacerbations may benefit from closer monitoring and additional interventions to achieve remission. This abstract is funded by: NHLBI
Gomez et al. (Fri,) studied this question.