Clinical Remission in Severe Asthma After 12 Months of Biologic Therapy: A Real-Life Cohort Study

With the introduction of biologic therapies for severe asthma, clinical remission has gained increasing relevance as a therapeutic goal; however, real-world data and validated predictors remain limited. We conducted a retrospective real-life study including 75 adults with severe asthma treated with mepolizumab, benralizumab, or dupilumab between October 2023 and September 2025. Clinical remission at 12 months was defined according to the multidimensional framework proposed by Menzies-Gow, requiring absence of oral corticosteroid use and exacerbations, ACT score > 20, and FEV1 > 80% predicted. Baseline clinical, functional, and biomarker variables were analyzed using bivariate tests and multivariable logistic regression with internal bootstrap validation. At 12 months, 37 of 75 patients (49.3%) achieved clinical remission. Peripheral eosinophilia ≥ 500 cells/µL, higher baseline FEV1, and the presence of gastroesophageal reflux disease were independently associated with remission, whereas age, body mass index, and grass pollen sensitization were not significant. The final model showed good discrimination and adequate calibration. In this monocentric real-life cohort, biologic therapy was associated with clinical remission in approximately half of patients, and selected baseline characteristics identified individuals with a higher probability of remission, warranting validation in larger multicenter studies.