“A second lease of life”: Patient insights on asthma remission

Background Treatment-induced clinical remission is an emerging therapeutic goal in severe asthma. Despite this, the perspectives of people with severe eosinophilic asthma (SEA) on remission remain unexplored. Objective We sought to understand how people with SEA treated with mepolizumab perceive remission and to compare the perspectives of those who have achieved remission with those who have not. Methods A qualitative study using one-to-one semi-structured interviews with 30 purposively sampled adult participants. Interview recordings were transcribed, audio verified and thematically analysed. Results Participants were mostly female (60%), with a mean± sd age of 64.8±11.02 years in the remission group and 68.6±8.66 years in the non-remission group. Four themes emerged: (i) making sense of remission: participants perceived asthma remission as a discernible point where the disease progression stopped/ceased; (ii) getting my life back: described perceived improvements in daily functioning, psychological well-being and quality of life; (iii) treatment goals and discontinuation: participants expressed preference to be symptom-free over being off-treatment; (iv) communication and timing: shared their ideal timing to discuss remission and their views on the role of multidisciplinary team in the remission discourse. Conclusion People with SEA defined asthma remission using individual metrics, including functional and emotional outcomes, highlighting restoration, normality and holistic well-being. Both groups consistently equated remission with freedom from OCS use and its negative consequences. Participants who achieved clinical remission described substantial perceived improvements in daily functioning, psychological well-being and quality of life. These findings can inform patient-clinician remission conversations, ensuring that it is discussed not only as a clinical outcome but also as a therapeutic goal shaped by patient priorities and expectations.