Clinical remission criteria for severe asthma defined by SANI group

14th August 2023

Criteria to define both complete and partial clinical remission in patients with severe asthma has been developed by the Severe Asthma Network Italy (SANI) group.

Published in the Journal of Allergy and Clinical Immunology in Practice, the SANI group set out to highlight a consensus for asthma remission using the Delphi technique.

A panel of 80 experts, which included pneumologists and allergists from the SANI network, covering 57 severe asthma centres, and more then 2,200 patients, were included in the Delphi process.

In the first Delphi round, the group created 32 statements, which were divided in four main categories: general questions about remission; criteria for clinical remission criteria; complete or partial clinical remission and its duration; and cut-off values of different scores regarding disease control, lung function and inflammation. Each of these statements used a five-point Likert scale to measure panellist’s agreement to each statement.

The statements were sent to the panellists and, following an interim analysis, the responses were discussed to produce a consistent questionnaire for the second round.

SANI group definition for clinical remission

During the second Delphi round, the criteria for complete clinical remission was confirmed as a composite of the absence for the need for oral corticosteroids (OCS); the absence of symptoms, exacerbations or attacks; and pulmonary stability. Moreover, these criteria had to be present for at least 12 months.

In contrast, partial clinical remission was defined where there was no further need for using
OCS, plus two out of the following three criteria: absence of asthma symptoms, absence of asthma
exacerbations or attacks, and pulmonary stability.

‘This SANI Delphi analysis defined a valuable, independent and easy-to-use tool to test the efficacy of different treatments in patients with severe asthma enrolled into the SANI registry,‘ the authors said.

Approximately 10-20% of people with asthma are estimated to have severe disease. The SANI group hopes that its definitions of complete and partial remission can be used to test the efficacy of different
treatments in patients enrolled and followed in the SANI registry.