An integrated post hoc analysis of the phase 3 SWIFT-1/-2 trials and the 52-week AGILE open-label extension, presented at the CHEST 2026 Annual Meeting in Phoenix, found patients in clinical remission with twice-yearly depemokimab (Exdensur) at the end of year 1 had fewer asthma exacerbations and greater lung function gains in year 2.¹,² Of 405 patients in the remission analysis set, 30% reached remission at the end of year 1, and 59% of these patients maintained it at the end of year 2.¹

Remission required no exacerbations across 52 weeks, no maintenance oral corticosteroids in the final 90 days, an Asthma Control Questionnaire (ACQ)-5 score < 1.5, and a forced expiratory volume in 1 second (FEV1) change from baseline of ≥ 0 mL.¹ During year 2, the annualized exacerbation rate was 0.19 (95% CI, 0.12–0.29) among patients in remission at year 1 vs. 0.69 (95% CI, 0.57–0.82) among patients not in remission.¹ From SWIFT-1/-2 baseline to the end of year 2, pre-bronchodilator FEV1 improved by 379 mL (95% CI, 301–458) vs 85 mL (95% CI, 33–137), and ACQ-5 score changed by −1.34 vs −0.71, respectively.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.³ Targeted biologics have made clinical remission a treatment goal in severe asthma, leaving clinicians to weigh how well remission holds once a patient reaches it.

In the following Q&A, Michael E. Wechsler, MD, professor of medicine and director of The Cohen Family Asthma Institute at National Jewish Health, spoke with HCPLive at CHEST 2026 about the durability of remission, twice-yearly dosing, treatment decisions for patients who fall short of remission, and how depemokimab fits among existing biologics.

Q&A: Asthma Remission from Year 1 to Year 2 with Depemokimab

HCPLive: Why is clinical remission now a realistic goal in severe asthma?

Michael Wechsler, MD, MMSc: We now have very effective therapies to treat patients with severe asthma. We are using targeted biologic therapies that target specific pathways involved in type 2 inflammation, and that's allowed us to get many of our patients into remission. By remission, we are talking about having no exacerbations, no oral corticosteroids, having normalized symptoms, and really achieving some improvement in FEV1 in lung function.

HCPLive: What does twice-yearly dosing change for patients and clinicians?

Michael Wechsler, MD, MMSc: When we offer patients twice-yearly dosing, it means that there's less of an impact on their day-to-day lives. They're not thinking about taking their medications.

If you have to take a drug every 2 weeks, every 4 weeks, even every 8 weeks, it's something you have to think about all the time. With twice-yearly dosage, it's much easier for patients to be more adherent and to potentially have better outcomes in the real world.

HCPLive: Why ask whether year 1 remission predicts year 2?

Michael Wechsler, MD, MMSc: It's important to ask who is most likely to stay in remission, and it’s usually people who’ve attained some degree of remission in the first year. If you analyze those people, you'll find that while about 30% of patients in the overall clinical trials achieve some degree of remission. If you take those people who've achieved remission, about 60% of those people are able to stay in remission. So, it gives you increasing confidence to continue to prescribe those therapies to those patients.

HCPLive: How durable was remission into the second year?

Michael Wechsler, MD, MMSc: Of the patients who attained remission in the first year, about 60% of those patients were able to continue to have remission in the second year. Those patients had no exacerbations, had stable or improved lung function, had no significant symptoms during that phase, and [had] no steroid use for their asthma.

HCPLive: 70% didn't reach remission in year 1. Should they stay on the therapy?

Michael Wechsler, MD, MMSc: With most therapies, you want to try to find the right drug for the right patient, and remission is a pretty high bar to achieve. While our ultimate goal is remission, many patients achieve some benefits, so not everyone has complete elimination of exacerbations. But about 50% of exacerbations are reduced or eliminated with biologic therapies, like depemokimab.

We need to recognize that not everyone's going to achieve remission, but they might still have benefits, and they might have benefits in terms of reduction in steroid dose, reduction in exacerbations, improvement in lung function, [and] improvement in symptoms. They may not necessarily achieve all of those, but I think achieving even any of those outcomes might have benefits for those patients.

HCPLive: Is this the right definition of remission?

Michael Wechsler, MD, MMSc: There are many different definitions of remission, and they take into account different thresholds. There's a big debate among experts about what remission [is], how we define remission, [and] over what duration of time [it is]. Is it 12 months? Is it 6 months? Is it 2 years or longer?

In this study, we used a 4-component definition of remission, but a 3-component definition of remission is also good.

Sometimes people start off [with] a high lung function, and if their FEV1 is 85%, they may not necessarily improve in terms of lung function. But if they have no exacerbations, whereas they had 2 exacerbations in the year prior, that is important.

HCPLive: Where does depemokimab fit among existing biologics?

Michael Wechsler, MD, MMSc: The addition of depemokimab into the armamentarium of biologics has been really important for us. It offers a distinct advantage in that it has every-6-month dosing. It has benefits in terms of patients with eosinophilic asthma.

It has benefits in terms of patients with chronic rhinosinusitis with nasal polyps. It's an important addition, and it's good to have a lot of options.

The way I choose a biologic for my patients is I look at the biomarker profile. I look at the comorbidities, I look at safety, I look at dosing, and all of those are important attributes that can be benefited by utilization of a drug like depemokimab.

References

1. 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.

2. Wechsler M. Depemokimab Year 1 Remission Linked to Better Year 2 Asthma Outcomes. HCPLive. Published October 21, 2026. Accessed November 3, 2026. https://www.hcplive.com/view/depemokimab-year-1-remission-linked-better-year-2-asthma-outcomes

3. Brooks A. FDA Approves Depemokimab-ulaa (Exdensur) for Severe Asthma. HCPLive. Published December 16, 2025. Accessed November 3, 2026. https://www.hcplive.com/view/fda-approves-depemokimab-ulaa-exdensur-for-severe-asthma