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New Clinical Advances in Chronic Asthma

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Respiratory Medicine".

Deadline for manuscript submissions: 20 November 2025 | Viewed by 2328

Special Issue Editor


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Guest Editor
Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University “Aldo Moro” of Bari, 70121 Bari, Italy
Interests: asthma; chronic obstructive pulmonary disease; pneumonia; bronchitis; respiratory insufficiency; snoring; tuberculosis; pulmonary mycobacteriosis; chronic respiratory insufficiency
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Special Issue Information

Dear Colleagues,

Chronic asthma is a multifaceted inflammatory disorder of the airways characterized by recurrent symptoms such as wheezing, breathlessness, and coughing. The landscape of asthma management has significantly evolved, with recent advances focusing on personalized treatment strategies, novel biologic therapies, and the concept of asthma remission.

Asthma management has traditionally aimed at symptom control and prevention of exacerbations through the use of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABAs). However, a deeper understanding of asthma's heterogeneity has led to more refined, phenotype-driven approaches, with a growing emphasis on disease modification and remission.

The future of asthma management lies in the continued refinement of personalized treatment approaches, particularly through the use of new biologics targeting alarmins and other novel pathways. Research is ongoing to identify additional biomarkers and therapeutic targets, which will enable even more precise and effective treatments. Ultimately, the goal is to shift the focus from merely controlling asthma to potentially curing it through sustained remission.

This Special Issue on chronic asthma gives updates on current clinical research developments. Original research articles and reviews are welcome.

Dr. Vitaliano Nicola Quaranta
Guest Editor

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Keywords

  • chronic asthma
  • breathlessness
  • coughing
  • inhaled corticosteroids (ICS)
  • long-acting beta-agonists (LABAs)
  • personalized treatment
  • chronic rhinosinusitis
  • nasal polyps
  • bronchiectasis
  • endotypes
  • oral corticosteroids

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Published Papers (2 papers)

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Research

19 pages, 2216 KiB  
Article
Long-Term Clinical Remission on Benralizumab Treatment in Severe Eosinophilic Asthma: A Four-Year Real-Life Study
by Carla Maria Irene Quarato, Pasquale Tondo, Donato Lacedonia, Piera Soccio, Dalila Pescatore, Maria Lisa Baccellieri, Giorgia Lepore, Maria Pia Foschino Barbaro and Giulia Scioscia
J. Clin. Med. 2025, 14(6), 2075; https://doi.org/10.3390/jcm14062075 - 18 Mar 2025
Viewed by 760
Abstract
Background: The current availability of monoclonal antibodies against key mediators of type-2 (T2) inflammation has led to a redefinition of the ultimate objectives of severe asthma treatment to a more composite concept of disease remission. Objectives: The aim of this real-life study was [...] Read more.
Background: The current availability of monoclonal antibodies against key mediators of type-2 (T2) inflammation has led to a redefinition of the ultimate objectives of severe asthma treatment to a more composite concept of disease remission. Objectives: The aim of this real-life study was to estimate the percentage of patients who achieved clinical remission over 4 years of treatment with benralizumab, and to identify baseline predictors for the achievement of such a composite outcome in the long term. Methods: Data from a 4-year follow-up of 23 patients who were prescribed benralizumab as an add-on therapy because of uncontrolled severe eosinophilic asthma were retrospectively analyzed and compared. Clinical remission was considered to be “complete” if oral corticosteroid (OCS) use was not required, there were no exacerbations, an asthma control test (ACT) score ≥ 20 was achieved and a pre-bronchodilation percent predicted a forced expiratory volume in 1 s (FEV1%) ≥ 80%. Clinical remission was considered to be “partial” if OCS use was not required, plus at least two of the other three aforementioned criteria. Results: The overall percentage of patients who achieved clinical remission was 86.9% after 12 months, and 91.3% after 24 and 48 months of treatment. The rate of complete remission over partial remission increased over time. After 12 months of treatment, 65% of patients fulfilled the criteria for complete remission and 35.0% for partial remission. After 48 months of treatment, 71.4% of patients were in a status of complete remission and 28.6% in a status of partial remission. A long-term composite outcome of complete clinical remission was more likely to be achieved by severe eosinophilic asthma patients with comorbid nasal polyposis, bronchiectasis and osteoporosis, and with OCS dependency, a predicted pre-bronchodilation FEV1% ≥ 80% and a predicted FEF25–75% < 65% at baseline. Conclusions: Our real-life experience suggests that treatment with benralizumab may allow the achievement and long-term maintenance of clinical remission in a high percentage of severe eosinophilic asthma patients, up to 4 years of follow-up. Full article
(This article belongs to the Special Issue New Clinical Advances in Chronic Asthma)
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15 pages, 1139 KiB  
Article
Clinical Remission Predictors in Non-Colonized Bronchiectasis and Severe Asthma with Type 2-Targeted Biologic Therapy: A Retrospective Real-Life Pilot Study
by Vitaliano Nicola Quaranta, Andrea Portacci, Francesca Montagnolo, Silvano Dragonieri, Ilaria Iorillo, Ernesto Lulaj, Leonardo Maselli, Enrico Buonamico and Giovanna Elisiana Carpagnano
J. Clin. Med. 2024, 13(21), 6309; https://doi.org/10.3390/jcm13216309 - 22 Oct 2024
Viewed by 1120
Abstract
Background/Objective: Patients with severe asthma (SA) and non-cystic fibrosis bronchiectasis (BE) without microbiological colonization represent a unique and understudied population. Type 2-targeted biologic therapies have emerged as a promising treatment for these patients. However, predictive factors for achieving clinical remission remain unclear. This [...] Read more.
Background/Objective: Patients with severe asthma (SA) and non-cystic fibrosis bronchiectasis (BE) without microbiological colonization represent a unique and understudied population. Type 2-targeted biologic therapies have emerged as a promising treatment for these patients. However, predictive factors for achieving clinical remission remain unclear. This study aims to identify the predictive factors for achieving clinical remission in patients with severe asthma and non-colonized bronchiectasis undergoing type 2-targeted biologic therapies. Methods: A retrospective longitudinal analysis was conducted on 14 patients with severe asthma and non-cystic fibrosis bronchiectasis without microbiological colonization. Clinical remission was assessed at baseline (T0) and after 12 months (T1) of biologic therapy. Clinical remission was defined according to the Severe Asthma Network Italy (SANI) criteria, including the absence of oral corticosteroid use, no asthma-related symptoms, stable lung function, and no exacerbations. Logistic regression was performed to identify predictors of remission. ROC curves were constructed to evaluate the predictive accuracy of lung function parameters, specifically FEV1 and FVC. Results: After 12 months of biologic therapy, 28.6% of patients (n = 4) achieved clinical remission. The mean FEV1 percentage at baseline was significantly higher in the remission group (92.25 ± 15.64%) compared to the non-remission group (65.10 ± 23.36%, p = 0.034). Logistic regression analysis identified baseline FEV1 as a significant predictor of remission (OR = 1.008, p = 0.050). ROC curve analysis revealed that an FEV1 cutoff of 72.5% had a sensitivity of 100% and a specificity of 70% (AUC = 0.900, p = 0.024) for predicting clinical remission. Conclusions: FEV1 is a crucial predictor of clinical remission in patients with severe asthma and non-colonized bronchiectasis treated with type 2-targeted biologic therapies. An FEV1 threshold of 72.5% can guide clinicians in identifying patients most likely to achieve remission. These findings underline the importance of preserving lung function to optimize therapeutic outcomes in this complex population. Full article
(This article belongs to the Special Issue New Clinical Advances in Chronic Asthma)
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