Consensus of Korean Asthma Study Group on Definition of Clinical Remission in Severe Asthma: A Modified Delphi Study
10.4046/trd.2025.0161
- Author:
Sun Hye SHIN
;
Joon Young CHOI
;
Junghee YOON
;
Youlim KIM
;
Jong Geol JANG
;
Ji-Yong MOON
;
Chin Kook RHEE
;
Kyung Hoon MIN
;
Yong Il HWANG
;
Yeon-Mok OH
;
Seong Yong LIM
;
- Publication Type:Original Article
- From:Tuberculosis and Respiratory Diseases
2026;89(2):215-225
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Asthma remission has recently emerged as an aspirational treatment goal, yet its definition remains inconsistent across studies and expert groups. The absence of a standardized framework hampers its application in clinical practice and research, particularly in Korea where biologics use is rapidly increasing. This study aimed to establish a consensus definition of clinical remission in severe asthma among Korean experts.
Methods:A two-round modified Delphi survey, followed by a focused third round, was conducted among 28 board-certified pulmonologists from the Korean Academy of Tuberculosis and Respiratory Diseases (KATRD). The questionnaire consisted of six domains and 27 items. Responses were analyzed using agreement rates, interquartile ranges, and content validity ratios to determine consensus levels.
Results:Consensus was reached on defining clinical remission as a composite of no exacerbations, no systemic corticosteroid use, sustained symptom control (Asthma Control Test ≥20 on at least three occasions over 12 months), and stabilization and optimization of pulmonary function while on maintenance treatment. Experts agreed that pulmonary function should be assessed based on clinical judgment rather than absolute thresholds. Complete remission was additionally defined as fulfilling all clinical remission criteria with normalization of type 2 inflammation (blood eosinophils <300/μL and fractional exhaled nitric oxide <25 ppb).
Conclusion:This Delphi consensus provides a regionally relevant and pragmatic framework for defining remission in severe asthma. These statements may help guide clinical practice, inform guideline development, and support future research on remission as a treatment goal.
