C33-09 Clinical Remission With Beclometasone/formoterol/glycopyrronium in Asthma: Real-world Evidence From the Trimaximize Study

Rationale Clinical remission is a new goal in asthma management. Clinical remission has been extensively studied in patients requiring biologic treatment, however, it remains largely unexplored in patients with inhaled therapies only. In the TriMaximize study, we investigated the clinical remission in moderate-to-severe asthma patients treated with extrafine formulation single-inhaler triple therapy consisting of beclometasone dipropionate/formoterol fumarate/glycopyrronium (BDP/FF/G) in a real-world setting. Methods TriMaximize is a multinational, observational study following asthma patients prescribed BDP/FF/G over one to three years. Patients were recruited at 165 sites across Germany, United Kingdom, Austria, Denmark, France, Spain, Poland and Italy. Data were analyzed descriptively. Two-component remission (2-CR) was defined by an absence of exacerbations and systemic corticosteroid use for at least one year, three-component remission (3-CR) was defined by an additional ACT score ≥ 20 and four-component remission (4-CR) was defined by an additional lung function criterion (improvement in FEV1 or decline of ≤ 5% predicted in FEV1 compared with baseline). Results A total of 1,445 patients (62.8% female; mean age: 57.6 years) were included in the study. The majority (72.7%) had previously been treated with ICS/LABA (fixed or free) and 27.3% had received ICS/LABA/LAMA (fixed or free). One year after initiating extrafine formulation BDP/FF/G therapy, 79.5% of patients achieved 2-CR. Furthermore, 45.6% of patients met the criteria for 3-CR, and 39.5 % achieved 4-CR. In the following 2 years of treatment with BDP/FF/G, the proportion of patients with 2-CR increased to 84.1%, with 3-CR to 59.3% and with 4-CR to 47.9 %. Conclusion Clinical remission can be achieved in a large proportion of patients after 1 year of BDP/FF/G treatment in a real-world setting, and this proportion further increases in the following years.