Roads to remission: evolving treatment concepts in type 2 inflammatory diseases

Lommatzsch M, Blumchen K, Beck LA, Bousquet J, Brusselle GG, Fokkens WJ, Hamelmann E, Lau S, Ott H, Pfaar O, Sampson HA, Smolen JS, Taube C, Tarner IH, Wagenmann M, Werfel T, Worm M, Renz H. EClinicalMedicine. 2025 Jan 8;80:103050. doi: 10.1016/j.eclinm.2024.103050.

Summary

Biomarkers and anti-inflammatory strategies in type 2 diseases.

Non-communicable diseases (NCDs) characterised by type 2 inflammation, including asthma, allergic rhinitis, chronic rhinosinusitis with nasal polyps, atopic dermatitis, food allergies and eosinophilic esophagitis, are increasing in prevalence worldwide. Currently, there is a major paradigm shift in the management of these diseases, towards the concept of disease modification and the treatment goal remission, regardless of severity and age.

Remission as a treatment goal in chronic inflammatory NCDs was first introduced in rheumatoid arthritis, and then adopted in other non-type 2 inflammatory diseases. Among diseases with type 2 Inflammation, this concept is novel and currently most advanced in asthma. This new paradigm has been developed based on a better understanding of the pathophysiology of type 2 inflammation and the advent of highly effective drugs selectively interfering with type 2 pathways. Here, we review the evolution of the new remission concepts in type 2 inflammatory diseases and discuss associated challenges and future research needs.

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