With novel therapies in development, there is an opportunity to consider asthma remission as a treatment goal. In this Rostrum, we present a generalized framework for clinical and complete remission in asthma, on and off treatment, developed on the basis of medical literature and expert consensus. A modified Delphi survey approach was used to ascertain expert consensus on core components of asthma remission as a treatment target. Phase 1 identified other chronic inflammatory diseases with remission definitions. Phase 2 evaluated components of those definitions as well as published definitions of spontaneous asthma remission. Phase 3 evaluated a remission framework created using consensus findings. Clinical remission comprised 12 or more months with (1) absence of significant symptoms by validated instrument, (2) lung function optimization/stabilization, (3) patient/provider agreement regarding remission, and (4) no use of systemic corticosteroids. Complete remission was defined as clinical remission plus objective resolution of asthma-related inflammation and, if appropriate, negative bronchial hyperresponsiveness. Remission off treatment required no asthma treatment for 12 or more months. The proposed framework is a first step toward developing asthma remission as a treatment target and should be refined through future research, patient input, and clinical study.

中文翻译：

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哮喘缓解的专家共识框架作为治疗目标。

随着新疗法的发展，有机会将哮喘缓解视为治疗目标。在这个讲台上，我们提出了基于医学文献和专家共识而开发的，哮喘的临床和完全缓解的总体框架。改良的Delphi调查方法用于确定专家共识，将哮喘缓解的核心成分作为治疗目标。第1阶段用缓解定义确定了其他慢性炎症性疾病。第2阶段评估了这些定义以及自发性哮喘缓解的已发布定义的组成部分。第三阶段评估了使用共识结果创建的缓解框架。临床缓解期为12个月或更长时间，其中（1）使用经过验证的仪器没有明显症状，（2）肺功能的优化/稳定，（3）患者/提供者对缓解的同意，以及（4）不使用全身性皮质类固醇。完全缓解的定义为临床缓解加上哮喘相关炎症的客观缓解，必要时还可消减支气管高反应性。缓解治疗不需要12个月或更长时间的哮喘治疗。拟议的框架是朝着将哮喘缓解发展为治疗目标迈出的第一步，应通过未来的研究，患者意见和临床研究加以完善。缓解治疗不需要12个月或更长时间的哮喘治疗。拟议的框架是朝着将哮喘缓解发展为治疗目标迈出的第一步，应通过未来的研究，患者意见和临床研究加以完善。缓解治疗不需要12个月或更长时间的哮喘治疗。拟议的框架是朝着将哮喘缓解发展为治疗目标迈出的第一步，应通过未来的研究，患者意见和临床研究加以完善。