Pushing Toward Asthma Remission With New Endpoints, Imaging Advances

At the recent American College of Allergy, Asthma & Immunology (ACAAI) annual meeting, experts discussed the evolving concept of asthma remission as a key goal for both clinicians and patients.

In this exclusive MedPage Today video, Njira Lugogo, MD, a pulmonologist at the University of Michigan in Ann Arbor, discusses some of the exciting developments that will shape the future of treatment for severe asthma, including targeted agents, making remission a goal of treatment, and the increased use of imaging.

Following is a transcript of her remarks:

So we are at the precipice of defining some new endpoints for our patients, and I feel like remission is one of those things that’s aspirational, both for clinicians and for patients.

I like the idea of remission for a couple of reasons. One, it’s a multifaceted outcome. It includes lung function changes, exacerbation reduction, oral corticosteroid sparing, plus/minus the presence of improvements in the utilization of background therapy, and of course asthma control measures. And it sort of highlights how treating asthma really requires you to think about all the different components that contribute to a patient’s presentation and also to response.

And then, the idea that we are starting to veer into a more translational space with regards to imaging. And in the past, we really didn’t do much imaging in asthma. We sort of felt like most of the imaging was normal, or perhaps you saw a little bit of bronchiectasis and maybe some mild air trapping, but we really didn’t think those were clinically meaningful outcomes. But now we know that there’s mucus plug scores that appear to have clinical implications in terms of lung function-declining exacerbations. They respond to treatments with our targeted therapies. We have computational measures that can tell us if people have small airway disease, air trapping, decreased lung volumes or increased lung volumes, and changes in resistance. And I think all of these things are really pushing us into the next frontier in terms of truly understanding what’s happening on a patient level.

And lastly, we can share all this with our patients. People want to know what they might expect from treatment with severe asthma. We have a very robust pipeline of clinical trials with multiple new targeted therapies and novel interventions. So we just really need to close the gap between discovery and treating our patients, enabling them to have those outcomes that all of us would want.