Sustained Asthma Remission and Reduced RElapse Using a COmprehensive Management Strategy Randomized Control Trial (SARRE-COMS)

Inclusion Criteria:

• • Patient understands study procedures and is will to participate in the study as indicated by the patient's signature.

  • Provision of written, informed consent prior to any study specific procedures.
  • Males and females ≥ 18 years of age.
  • Diagnosis of severe asthma, as defined by ATS/ERS guidelines (requiring high-dose ICS plus second controller and/or OCS, or uncontrolled despite this therapy).
  • Eligible for initiation of biologic therapy for treatment of asthma.
  • Women of childbearing potential (after menarche) must ensure that they are using an effective form of birth control for at least 2 months prior to each imaging visit. Examples of effective birth control include:
  • True sexual abstinence
  • A vasectomized sexual partner
  • Implanon®
  • Female sterilization by tubal occlusion
  • Effective intrauterine device (IUD)/levonogestrel intrauterine system (IUS)
  • Depo-Provera™ injections
  • Oral contraceptive
  • Evra Patch™
  • Nuvaring™
  • Women of childbearing potential (after menarche) must agree to use a highly effective form of birth control, as defined above, from enrollment, throughout the study duration, and X weeks after last dose of study drug, with negative urine pregnancy test result at Visit 1 and Visit 5.
  • Male participants who are sexually active must agree to use a double barrier method of contraception (male condom with diaphragm or male condom with cervical cap) from the first dose of the study drug until X weeks after last dose.

Exclusion Criteria:

• • Primary respiratory diagnoses other than asthma (e.g., COPD, bronchiectasis).

  • Patients with incomplete medical records.
  • Patients who have received biologic treatment for asthma within the last 6 months.
  • Patient has an implanted mechanically, electrically, or magnetically activated device or any metal in their body which cannot be removed, including but not limited to pacemakers, neurostimulators, biostimulators, implanted insulin pumps, aneurysm clips, bioprosthesis, artificial limb, metallic fragment or foreign body, shunt, surgical staples (including clips or metallic sutures and/or ear implants) (at the discretion of the MRI Technologist).
  • In the investigator's opinion, subject suffers from any physical, psychological or other condition(s) that might prevent performance of the MRI or CT, such as severe claustrophobia.
  • Patients with contraindications to PFT, sputum induction, CT or MRI imaging.
  • Patients who are pregnant or breastfeeding.
  • Patients who are unable or unwilling to comply with study procedures.