Contemporary Concise Review 2025: Asthma.

Abstract

Asthma research in 2025 further advanced a multidimensional view of asthma, integrating disease trajectory, exacerbation risk, structural airway changes, comorbidities, and treatment responsiveness. In mild asthma, studies published in 2025 further reinforced the importance of anti-inflammatory reliever strategies over SABA-only treatment by supporting timely inhaled corticosteroid delivery at symptom worsening to reduce exacerbation risk, particularly in adults and adolescents, while providing emerging but still nuanced evidence in child. In severe asthma, the therapeutic focus expanded beyond exacerbation reduction towards disease modification, including oral corticosteroid sparing, improvement or normalisation of lung function, reduction of mucus plugging, and attainment of clinical remission. Clinical remission became more clearly defined and increasingly positioned as a treatment target and research endpoint, supported by emerging consensus definitions, real-world data, and analyses of biologic trials. Real-world asthma management increasingly emphasised implementation, including treatable-traits-based care, biomarker-informed stratification, digital inhaler technologies, and approaches to persistent ethnic, social, and age-related inequities in outcomes. Advances in pathobiology highlighted the central role of the airway epithelium, inflammatory cellular ecosystems, microbiome-associated endotypes, mucus-plug biology, and early-life origins of airway remodelling in shaping asthma heterogeneity and progression.