Is it possible to achieve remission in severe asthma? Retrospective analysis of a four-year response in a real-life cohort treated with mepolizumab.

Response to biologics in severe uncontrolled asthma (SUA) can be classified as super-responders, good responders, non-responders, and those achieving clinical remission. The aim of this study is to evaluate the long-term response to mepolizumab in patients with severe eosinophilic asthma and assesses the rate of asthma clinical remission over four years in a real-life setting. This is a single-center, observational, retrospective study was conducted at La Paz University Hospital (Madrid, Spain) from 2017 to 2022. Patients with SUA treated with mepolizumab 100mg every four weeks for at least three years were included. Response to mepolizumab was classified into good responders, super-responders, non-responders, and patients achieving clinical remission after three and four years of treatment. 27 patients (67% women; mean age 37.7 years) were included. 58% of patients achieved remission after three years of treatment, increasing to 63% after four years. Similar trends were observed in super-responders and good responders. We found that a significant number of patients treated with mepolizumab in a real-life setting can achieve asthma remission, particularly when compared to other similar studies. By distinguishing these different degrees of response, clinicians can better understand the patient's condition and make more informed decisions about whether to continue with the current biologic therapy or consider switching to a different treatment.