Patients with type 2 asthma who reached clinical remission with twice-yearly depemokimab (Exdensur) in year 1 had fewer exacerbations and greater lung function gains in year 2, according to an integrated analysis presented at the CHEST 2026 Annual Meeting in Phoenix.¹
Depemokimab, an ultra-long-acting interleukin-5 (IL-5) antagonist, received FDA approval in December 2025 as add-on maintenance treatment for severe asthma with an eosinophilic phenotype in patients aged 12 years and older.² In the 52-week phase 3 SWIFT-1/-2 trials, 29% of patients receiving depemokimab achieved 4-component clinical remission at week 52, compared with 23% of patients receiving placebo.¹ The new analysis asked whether remission status at the end of year 1 carried forward into a second year of continuous treatment.
“If you can achieve remission with a specific therapy, you’re more likely to continue to stay in remission,” said Michael E. Wechsler, MD, MMSc, professor of medicine and director of The Cohen Family Asthma Institute at National Jewish Health. “It gives [us] confidence that the therapy is working and that patients will continue to do well with that therapy.”
Depemokimab Clinical Remission Durability in SWIFT and AGILE
The integrated post hoc analysis included patients who received depemokimab across both the SWIFT-1/-2 trials and the 52-week AGILE open-label extension study.¹ Investigators defined 4-component clinical remission as no exacerbations across 52 weeks, no maintenance oral corticosteroid use in the final 90 days, an Asthma Control Questionnaire (ACQ)-5 score < 1.5, and a change from baseline in forced expiratory volume in 1 second (FEV1) of ≥ 0 mL.¹
Of 419 patients treated with depemokimab in both years, 405 entered the clinical remission analysis set.¹ A total of 30% (123/405) achieved clinical remission at the end of year 1, and 59% (73/123) of these patients maintained remission at the end of year 2.¹ The remaining 70% did not reach remission in year 1.¹
During year 2, the annualized exacerbation rate was 0.19 (95% CI, 0.12–0.29) among patients in remission at year 1, compared with 0.69 (95% CI, 0.57–0.82) among patients not in remission.¹ Wechsler noted patients who sustained remission into year 2 had no exacerbations, stable or improved lung function, no significant symptoms, and no steroid use for asthma.
Depemokimab Year 2 Outcomes in FEV1, ACQ-5, and SGRQ Scores
Patients achieving remission at the end of year 1 showed greater improvements across all 3 secondary outcomes at the end of year 2, measured as least squares mean change from SWIFT-1/-2 baseline.¹ St George’s Respiratory Questionnaire (SGRQ) total score improved by −23.57 points (95% CI, −26.53 to −20.62) in the remission group vs −13.15 points (95% CI, −15.13 to −11.17) in the nonremission group.¹
ACQ-5 score changed by −1.34 (95% CI, −1.51 to −1.17) in patients with year 1 remission vs −0.71 (95% CI, −0.82 to −0.60) in patients without remission.¹ Pre-bronchodilator FEV1 improved by 379 mL (95% CI, 301–458) vs 85 mL (95% CI, 33–137), respectively.¹ The trend remained consistent at every assessed timepoint during year 2.¹
Wechsler emphasized the 70% of patients not meeting the 4-component definition in year 1 may still benefit from continued treatment. He described remission as a high bar and noted ongoing debate among experts on which components and what duration should define it.
“Not everyone’s going to achieve remission, but they might still have benefits,” Wechsler said. “They might have benefits in terms of reduction in steroid dose, reduction in exacerbations, improvement in lung function, [and] improvement in symptoms.”
He added a 3-component definition without a lung function criterion may better fit patients with a near-normal baseline FEV1, for whom eliminating prior exacerbations is the more meaningful outcome.
“Sometimes some people start off [with] a high lung function,” he said. “If their FEV1 is 85%, they may not necessarily improve in terms of lung function. Whereas if they had two exacerbations in the year prior, that is important.”
Editor’s note: Reported disclosures for Wechsler include GENZYME CORPORATION, GlaxoSmithKline, Regeneron Healthcare Solutions, and more.
References
Wechsler ME, Tacon CE, Muccino D, et al. Attainment of clinical remission with twice-yearly depemokimab in year 1 is associated with improved clinical outcomes in year 2: SWIFT/AGILE integrated analysis. Presented at: CHEST 2026; October 20, 2026; Phoenix, AZ.
