Background: Severe asthma, which is characterized by persistent symptoms despite standard therapies, presents a significant clinical challenge. Biologic therapies targeting specific inflammatory pathways offer a potential avenue for achieving disease remission. This retrospective study evaluates the effectiveness of biologic therapies in achieving remission in severe asthma within a central Romanian cohort. Methods: Forty-eight patients with severe asthma treated with omalizumab, benralizumab, or dupilumab (2020–2025) were assessed. Clinical remission was defined using ACT scores, exacerbation frequency, corticosteroid use, and FEV1. Biological remission was determined using FeNO and eosinophil levels. Statistical analysis was performed to compare treatment outcomes. Results: At 12 months, 75% of patients achieved biological remission, and 75% reached clinical remission criteria. Significant improvements were observed in FEV1 (p < 0.001), eosinophil counts (p < 0.001), and ACT scores (p < 0.001). Complete remission, encompassing clinical, biological, and functional normalization, was observed in 54.2% of patients. Conclusion: Biologic therapies demonstrate promise in inducing comprehensive remission in severe asthma, supporting their role in improving disease control and lung function. Further research with larger cohorts is warranted.

Background: Severe asthma remains associated with substantial morbidity despite optimized inhaled therapy. Biologic agents targeting type 2 inflammation improve clinical outcomes; however, real-world evidence regarding the durability of these effects beyond the first treatment year remains limited. The present study extends the follow-up of a previously reported real-world cohort in which 12-month outcomes of biologic therapy were evaluated. Methods: We conducted a retrospective observational longitudinal study of adults with severe asthma treated with omalizumab, benralizumab, or dupilumab at a tertiary center in Târgu-Mureș, Romania, between 2020 and 2025, extending follow-up of a previously published real-world cohort. The same patient cohort was followed for an additional period, with longitudinal data collected up to 24 months after biologic therapy initiation. Clinical, functional, and biomarker outcomes were assessed at baseline, 12 months, and 24 months, including Asthma Control Test (ACT) score, forced expiratory volume in one second (FEV₁% predicted), annual exacerbation rate, blood eosinophil count, and fractional exhaled nitric oxide (FeNO). Remission was defined as clinical (ACT ≥ 20, no severe exacerbations, and no maintenance oral corticosteroids), biological (FeNO < 20 ppb and blood eosinophils < 150/µL), and complete (both clinical and biological). Longitudinal changes were analyzed using the Friedman test with post hoc Wilcoxon signed-rank tests. Results: Forty-eight patients were included at baseline, and 41 had available data at 24 months. ACT scores improved from 12 (IQR 11–14) at baseline to 23 (21–25) at 12 months and remained stable at 22 (20–25) at 24 months (p < 0.001). Predicted FEV₁% increased from 50 (39–59) to 78 (68–88) at 12 months and 79 (66–96) at 24 months (p < 0.001). Blood eosinophil counts were markedly suppressed, and FeNO levels continued to decrease over time. Exacerbations declined from 2 (2–3) per year at baseline to 0 and 0.5 (0–1) at 12 and 24 months, respectively (p < 0.001). At 24 months, clinical, biological, and complete remission were observed in 61.0%, 78.0%, and 41.5% of patients with available paired data, respectively. Conclusions: Biologic therapy was associated with sustained clinical and functional improvement over 24 months, accompanied by sustained improvement in type 2 airway inflammation and increasing proportions of patients meeting remission criteria in real-world practice.

Background: Breaking bad news (BBN) represents one of the most behaviorally and emotionally demanding communication skills in medical practice, particularly for residents who are still developing their professional and interpersonal competencies. Despite its ethical and psychological complexity, structured communication training remains insufficiently integrated into residency curricula in Romania. Methods: This cross-sectional, single-center study explored the behavioral preparedness, attitudes, and perceived training needs of Romanian medical residents regarding BBN. A total of 193 residents from multiple specialties at Mureș County Clinical Hospital, Târgu Mureș, completed a self-administered questionnaire assessing their experiences, emotional reactions, perceived barriers, and familiarity with communication protocols such as SPIKES. Participation was voluntary, responses were anonymous, and completion of the questionnaire implied informed consent. Results: Most respondents (94.3%) acknowledged the importance of BBN, yet only 31.6% had practical experience, and 17.6% reported formal training. Awareness and use of structured communication frameworks were limited but correlated with greater confidence and empathy. Experience increased with residency year and varied across specialties. Conclusions: Romanian medical residents recognize the ethical and emotional significance of breaking bad news but lack structured educational preparation. The findings underline the need for targeted behavioral and educational interventions to strengthen residents’ preparedness, emotional resilience, and patient-centered communication competence. Trial registration: Not applicable.