REIMAGINE: A prospective real-world evaluation of clinical remission in patients with severe asthma treated with mepolizumab in a timely manner

<bold>Background:</bold> Clinical remission (CR) in severe asthma (SA) is an ambitious and achievable treatment goal; further prospective real-world analyses are needed to determine the impact of timely intervention on achieving CR. <bold>Aims:</bold> REIMAGINE prospectively evaluates the proportion of a subset of patients with SA with an eosinophilic phenotype (EP) achieving CR with mepolizumab and clinical characteristics influencing CR status. <bold>Methods:</bold> This global, prospective, real-world, 2-year study enrolled adult patients with SA-EP newly prescribed mepolizumab. Inclusion criteria: predicted FEV₁ ≥60%, ≤4 exacerbations/year, no maintenance systemic corticosteroid use. Primary outcome: proportion of patients achieving CR. Here we report interim baseline data. <bold>Results:</bold> As of 20/2/2025, 177 patients were enrolled (Table). Mean (SD) asthma duration was 38.4 (23.1) years; exacerbation rate in the year before mepolizumab was 1.7 (0.9) as of 25/2/2025. Comorbidities included allergic rhinitis (37.9%) and nasal polyps (14.7%). The mean (SD) Asthma Control Test score was 14.8 (4.6) indicating poorly controlled asthma. Quality of life assessments reflected moderate impairment. <bold>Conclusions:</bold> This study will inform on CR outcomes when mepolizumab is introduced earlier in the SA disease progression, as shown by better baseline lung function than traditionally reported in RCTs. <bold>Funding:</bold> GSK (219871). <fig><object-id>erj;66/suppl_69/PA4626/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>