T2 biomarkers and remission state in severe asthma treated by biologics.

<bold>Introduction:</bold> Biologics are now the standard treatment for severe T2 high asthmatics who are not relieved by ICS-LABA high dose and can bring patients into clinical remission at one year in 30-40%. Different biologics (anti-IgE, anti-IL5, anti-IL5R, anti-TLSP, anti-IL4/13R) can be proposed depending on the immuno-inflammatory characteristics of the patients. Aims and objectives: Our aim was to see how asthmatics in remission at one year progressed and more precisely how their remission state at two years was impacted by their T2 markers. <bold>Methods:</bold> We conducted a longitudinal study on severe T2 high asthmatics brought in remission after one year of treatment with biologics (omalizumab, mepolizumab and benralizumab) (N=54). We separated these patients in two groups according to their T2 markers at one year with thresholds set at 25 ppb for FeNO, 150 103/mm3 for blood eosinophils and 3% for sputum eosinophils. <bold>Results:</bold> Most of the patients (81%) kept at least one T2 high biomarker at one year while being in remission. Looking at baseline features we didn’t find any significant difference for the FeNO, sputum eosinophils and the blood eosinophils between those who had remained T2 high or had become T2 low at one year. More surprisingly, we found that 63% of the T2 high patients at one year remained in remission at two years while remission was persistent in only 50% in those who were T2 low at one year for all biomarkers (p=0,48). <bold>Conclusion:</bold> Among severe T2 high asthmatics in remission after one year of treatment with biologics, keeping a T2 high biomarker does not jeopardize the chance of staying in remission one year later.