Bosi Annamaria, Lombardi Carlo, Caruso Cristiano, Cottini Marcello, Baglivo Ilaria, Colantuono Stefania, Menzella Francesco
Pulmonology Unit, S. Valentino Hospital, Montebelluna (TV), AULSS2 Marca Trevigiana, Italy.
Departmental Unit of Allergology, Clinical Immunology & Pneumology, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.
Drugs Context. 2024 Sep 23;13. doi: 10.7573/dic.2024-7-2. eCollection 2024.
Over the last two decades, we have witnessed great advancements in our understanding of the immunological pathways of asthma, leading to the development of targeted therapies, such as biologic drugs, that have radically and definitively changed the clinical outcomes of severe asthma. Despite the numerous therapeutic options available, ~4-10% of all people with asthma have severe or uncontrolled asthma, associated with an increased risk of developing chronic oral corticosteroid use, fixed airflow limitation, exacerbations, hospitalization and, finally, increased healthcare costs. The new concept of disease modification in asthma comes from the evolution of asthma management, which encompasses phenotyping patients with different inflammatory endotypes characterizing the disease, followed by the advent of more effective therapies capable of targeting the proximal factors of airway inflammation. This treat-to-target approach aims to achieve remission of the disease. Because the novel treatment paradigm for severe asthma with the advent of biologic therapies is no longer clinical control but rather clinical remission - a step closer to the concept of cure - a deeper and more accurate understanding of the critical causal mechanisms and endotypes of asthma is necessary to achieve the goal of clinical remission, which has the potential to generate real life-changing benefits for patients. This review aims to frame the evolution of the debated concept of clinical remission and provide clinicians with insights that may be helpful in achieving remission in the greatest number of patients.
Drugs Context. 2024-9-23
Respir Res. 2024-4-24
J Asthma Allergy. 2024-3-19
Respirology. 2023-8
Acta Dermatovenerol Croat. 2023-11
J Allergy Clin Immunol Pract. 2023-9
Respir Res. 2024-4-24
Curr Opin Pulm Med. 2024-5-1
J Allergy Clin Immunol Pract. 2024-4
Allergol Select. 2024-1-12
Lancet Respir Med. 2024-2