Long after the 2014 release of the European Respiratory Society and American Thoracic Society (ATS) paper reviewing the definition, evaluation and treatment of severe asthma, the search to find an effective treatment continues. The state of severe asthma and its effective treatments was the focus of the 2024 ATS Conference Scientific Symposium, “Emerging Strategies in Severe Asthma in 2024 and Beyond.”
This year’s symposium examined the three major biomarkers in severe asthma: eosinophils, exhaled nitric oxide and Immunoglobulin E (IgE). However, with significant overlap between the three, experts said more research is necessary to identify additional biomarkers as well as other novel therapies for targeted, personalized treatments.
“The field of asthma has evolved significantly over the last decade, and one of the most notable emerging concepts is novel biomarkers,” said Michael E. Wechsler, MD, MSc, professor of medicine at National Jewish Health in Denver, Colorado, and co-chair of the ATS Scientific Symposium.
Celeste Porsbjerg, MD, PhD, expanded the discussion of current and future targets and biomarkers in severe asthma. Dr. Porsbjerg is a professor of severe asthma at Bispebjerg Hospital in Copenhagen, Denmark.
The symposium also tackled the goal of achieving asthma remission, a relatively “new and aspirational concept in 2024,” Dr. Wechsler said. In fact, only 10-40% of patients achieve remission when assigned appropriate biological therapy regimens, he said.
“Remission is the notion that a person will have sustained control of their asthma. Usually, it’s evaluated at no less than a year, and during that year, they have no exacerbations, no corticosteroid use, normalization of lung function and minimal symptoms that interfere with daily activity,” Dr. Wechsler said. “The biological therapies available to us allow us to consider remission a realistic possibility.”
This year’s symposium also featured Global Initiative for Asthma (GINA) Science Committee Chairman, Helen Reddel, PhD, MBBS, FRACP, professor at Macquarie University in Syndey, Australia, who reviewed GINA’s recently released guidelines for managing and treating asthma.
Dr. Wechsler and Praveen Akuthota, MD, ATSF, professor of clinical medicine at the University of California in San Diego and symposium co-chair, concluded the symposium with a look at benchmarks for the advancement of severe asthma research.
“What can we offer patients with non-type 2 inflammation in asthma? Can we stop biologics in well-controlled patients and see if they can maintain control? What’s the best way to decide between one biologic versus another? What are other novel mechanisms we should be thinking about? Those are just a few of the unanswered questions yet to explore,” Dr. Wechsler said.
