On-Treatment Clinical Remission in Asthma Patients

Frequent OCS Use

Serious Exacerbations

Impaired Lung
Function

Poor Symptom Control

Frequent OCS Use^1,2

Having ≥2 exacerbations per year requiring an
OCS burst meets criteria for being uncontrolled.

Per GINA guidelines, low-dose maintenance OCS (≤7.5 mg/day prednisone equivalent) may be considered as a last resort treatment for some adults with severe asthma, but strategies to minimize side effects should be implemented.

GINA, Global Initiative for Asthma; OCS, oral corticosteroid.
1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated May 2024.
Accessed May 15, 2024. https://ginasthma.org/gina-reports/ 2. Chung KF, et al. Eur Respir J. 2014;43(2):343-373.

Serious Exacerbations^1,2

Having ≥1 serious exacerbation requiring hospitalization meets criteria for being uncontrolled.

1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated May 2024.
Accessed May 15, 2024. https://ginasthma.org/gina-reports/ 2. Chung KF, et al. Eur Respir J. 2014;43(2):343-373.

Impaired Lung Function^1,2

Having a pre-bronchodilator FEV₁ percent predicted <80% meets criteria for being uncontrolled.

FEV₁, forced expiratory volume in 1 second.
1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated May 2024.
Accessed May 15, 2024. https://ginasthma.org/gina-reports/ 2. Chung KF, et al. Eur Respir J. 2014;43(2):343-373.

Poor Symptom Control^1,2

Having an ACQ score ≥1.5, ACT score <20, frequent symptoms or reliever use, activity limitations, and/or night waking due to asthma meets criteria for being uncontrolled.

ACT, Asthma Control Test; ACQ, Asthma Control Questionnaire.
1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated May 2024.
Accessed May 15, 2024. https://ginasthma.org/gina-reports/ 2. Chung KF, et al. Eur Respir J. 2014;43(2):343-373.

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Morgan’s asthma remains uncontrolled^1,2

Having a pre-bronchodilator FEV₁ percent predicted <80% meets criteria for being uncontrolled.

Having ≥1 serious exacerbation requiring hospitalization meets criteria for being uncontrolled.

FEV₁, forced expiratory volume in 1 second.
1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated May 2024.
Accessed May 15, 2024. https://ginasthma.org/gina-reports/. 2. Chung KF, et al. Eur Respir J. 2014;43(2):343-373.

No Exacerbations

No OCS Use

Stabilized Lung
Function

Symptom Control
(ACQ <0.75^‡)

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Morgan’s asthma is controlled^1-6

No exacerbations in the previous 12 months
Pre-BD FEV₁ pp ≥80%
ACQ score <1.5
No reported symptoms

All of the proposed criteria for on-treatment clinical remission have been met:

No OCS
No exacerbations
Stabilized lung function
ACQ ≤0.75

However…
Morgan has not maintained these criteria for at least 12 months, so it is not yet evident that her disease control has reached the level of clinical remission

ACQ, Asthma Control Questionnaire; BD, bronchodilator; FEV₁pp, forced expiratory volume in 1 second percent predicted; OCS, oral corticosteroids.
1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated May 2024. Accessed May 15, 2024. https://ginasthma.org/gina-reports/. 2. Chung KF, et al. Eur Respir J. 2014;43(2):343-373. 3. Menzies-Gow A, et al. J Allergy Clin Immunol. 2020;145(3):757-765. 4. Thomas D, et al. Eur Respir J. 2022;60(5):2102583. 5. Lommatzsch M, et al. S2k guidelines for specialist diagnostics and treatment of asthma 2023 [in German]. Accessed March 8, 2024. https://register.awmf.org/assets/guidelines/020-009l_S2k_Fachaerztliche-Diagnostik-Therapie-von- Asthma_2023-03.pdf 6. Blaiss M, et al. Ann Allergy Asthma Immunol. 2023;131(6):782-785.

No Exacerbations

No OCS Use

Stabilized Lung
Function

Symptom Control
(ACQ <0.75^‡)

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Morgan’s asthma is controlled^1-4

No exacerbations in the previous 12 months
Pre-BD FEV₁ pp ≥80%
ACQ score <1.5
No reported symptoms

ACQ, Asthma Control Questionnaire; BD, bronchodilator; FEV₁pp, forced expiratory volume in 1 second percent predicted.
1. Menzies-Gow A, et al. J Allergy Clin Immunol. 2020;145(3):757-765. 2. Thomas D, et al. Eur Respir J. 2022;60(5):2102583. 3. Lommatzsch M, et al. S2k guidelines for specialist diagnostics and treatment of asthma 2023 [in German]. Accessed March 8, 2024. https://register.awmf.org/assets/ guidelines/020-009l_S2k_Fachaerztliche-Diagnostik-Therapie-von-Asthma_2023-03.pdf 4. Blaiss M, et al. Ann Allergy Asthma Immunol. 2023;131(6):782-785.

Morgan’s asthma is likely in clinical remission^1-4

By 18 months on treatment, Morgan has achieved
all of the proposed criteria for clinical remission and
maintained this level of disease control for ≥12 months:

No OCS use
No exacerbations
Stabilized lung function
ACQ score ≤0.75

ACQ, Asthma Control Questionnaire; OCS, oral corticosteroid.
1. Menzies-Gow A, et al. J Allergy Clin Immunol. 2020;145(3):757-765. 2. Thomas D, et al. Eur Respir J. 2022;60(5):2102583. 3. Lommatzsch M, et al. S2k guidelines for specialist diagnostics and treatment of asthma 2023 [in German]. Accessed March 8, 2024. https://register.awmf.org/assets/ guidelines/020-009l_S2k_Fachaerztliche-Diagnostik-Therapie-von-Asthma_2023-03.pdf 4. Blaiss M, et al. Ann Allergy Asthma Immunol. 2023;131(6):782-785.