Achieving Clinical Remission in Asthma Care, With Linda Rogers, MD

Clinical remission in asthma is no longer a distant goal—it’s an emerging reality for a subset of patients. In an interview with HCPLive, Linda Rogers, MD, a pulmonary medicine professor at Mount Sinai, discussed how biologic therapies and evolving treatment strategies are reframing what it means to manage asthma long term. At an upcoming pulmonary conference, hosted by Mount Sinai Respiratory Institute in New York from November 6 - 7, 2025, Rogers will present the session, "Clinical Remission In Asthma: A New Era Of Treating To Target.”1

Rogers described a notable shift in how clinicians define success. Traditional goals—fewer symptoms, reduced steroid use, and lower exacerbation rates—are giving way to deeper disease control. Some patients, she said, now experience months or even years without flare-ups, while maintaining normal activity levels and stepping down from daily inhaled therapies.

“It's been a really interesting evolution that I would say started to take off around 2020, during the pandemic, and [has] really escalated with the advent of many of our newer therapies, particularly our biologic drugs,” Rogers said. “When we started to see these really dramatic responses in some of our patients, with some of them stopping using inhalers of any kind, it really made us rethink whether something that we would term ‘clinical remission’ in asthma is possible.”

The concept of remission, she explained, typically involves 3 key elements: stopping daily oral corticosteroids, avoiding exacerbations requiring short steroid bursts for at least a year, and sustaining well-controlled symptoms verified through tools like the Asthma Control Test. Lung function may complement these criteria, though its role remains debated. Still, there is no standarized definition of clinical remission.2

In clinical practice, Rogers emphasized that tracking exacerbations outside the office visit is essential. Many flares go unreported or are treated at urgent care centers, leaving gaps in the clinical picture.

Patient mindset also shapes outcomes. Many adults have lived with asthma for decades and accept occasional flares as inevitable. Rogers encourages clinicians to reset expectations:

“The hardest scenario are the patients who have become accustomed to it and don't even think about it as something notable to tell you, and if you don't ask, you don't know,” Rogers said. “For me, I'm really mindful of this, and so I go back in our electronic record, and we can generally see what a patient has been filling at their pharmacy for the last year.”

By looking at records, Roger can tell when the patient has been prescribed steroids or antibiotics, and from there, when their last asthma episode took place. If a patient has been prescribed a second course of prednisone and still gets episodes, the provider may need to escalate therapy.

Despite promising data, the field still lacks a unified framework. Studies define remission inconsistently, making cross-trial comparisons difficult. Rogers advocates for a consensus that captures both clinical and biological remission, recognizing that symptom-free periods may not always reflect full inflammatory quiescence.

Looking ahead, she expects clinical trials to include remission as a predefined endpoint, similar to rheumatoid arthritis and inflammatory bowel disease. Early biologic initiation, coupled with biomarker-driven treatment selection, may further improve long-term outcomes.

Rogers said the promise of remission lies not just in fewer symptoms but in preventing future decline.

“We need to set the bar higher,” Rogers said. “We need to set the bar at no exacerbations for our patients with asthma, and whether that's with inhaled therapy, no exacerbations requiring prednisone or acute care or steroids in acute care, and whether that's with inhaled therapy or necessitates a biologic therapy, I think we need to really move more aggressively in escalating therapy in our patients who are not meeting treatment goals. I've been doing this now in asthma for upwards of 25 years, and I've never been more excited by the options of what I have for my patients, and it's going to be exciting to see what the next 10 years hold.”

Relevant disclosures for Rogers include Sanofi, Regeneron, AstraZeneca, and Gene D.

References

1. Rogers, L. Clinical Remission In Asthma: A New Era Of Treating To Target. Presented at Mount Sinai Respiratory Institute in New York from November 6 - 7, 2025.

2. Lommatzsch M, Virchow JC. Asthma remission: a call for a globally standardised definition. Lancet Respir Med. 2025;13(1):2-3. doi:10.1016/S2213-2600(24)00304-7