Clinical remission in adults with moderate-to-severe asthma

A new framework from Professor Celeste Porsbjerg’s team redefines remission in severe asthma by focusing on disease activity, not damage. Early, targeted treatment during the “at-risk asthma” phase may prevent lasting harm.

A new Lancet Respiratory Medicine Series paper places Danish research leadership in the spotlight. Professor Celeste Porsbjerg (Bispebjerg University Hospital, Copenhagen) and colleagues present a conceptual framework for remission in severe asthma that moves beyond symptoms and lung function, towards a biological definition of disease stability.

Introducing “At-Risk Asthma”

The authors introduce the concept of “at-risk asthma” – a phase marked by high disease activity and early remodelling, where timely treatment can still alter the disease trajectory. By intervening before irreversible damage occurs, clinicians may improve long-term outcomes and prevent progression to fixed airway obstruction and comorbidity-driven symptoms.

Key insight from the paper:

• Four central domains underpin asthma pathology:
  • airway hyper-responsiveness
  • airway immune hyper-responsiveness
  • immune remodelling
  • structural remodelling.
• A domain-based assessment strategy may help clinicians disentangle symptoms caused by active disease from those due to irreversible damage or comorbidities, enabling more personalised care.
• Timely, mechanism-based intervention during early disease stages offers the best chance for remission, while later structural changes are often resistant to therapy.

Ontime treatment shape long term outcomes
This biologically grounded framework reframes remission not as the absence of symptoms, but as the suppression of active disease biology. It also reinforces the central role of on-time treatment decisions in shaping long-term disease outcomes.

Read the full article here: The Lancet Respiratory Medicine, Sept 29, 2025