Treatable traits that impact the health of asthma and COPD patients
Published online: October 8, 2020
“Treatable Traits” was recently proposed as a new way to manage the health of people with airway diseases such as asthma and COPD. In this management strategy, health and behavioral problems that are related to or complicate airway disease - known as treatable traits – are systematically assessed using various tests and questionnaires, and then these problems are targeted with treatment. There are many treatable traits that are potentially relevant to managing airway diseases, including problems in the lung, such as airway inflammation or excessive mucus, and problems outside the lung, such as obesity or smoking. The question is how to identify which of many potentially relevant traits are the most important to assess and treat.
Hiles et al. recently published a study in The Journal of Allergy and Clinical Immunology: In Practice to help answer this question. The study used data from 91 patients who participated in 2 clinical trials of the treatable traits management approach. It investigated which of 22 treatable traits had the largest negative effect on the quality of life of patients, and which traits when treated led to the greatest improvement in quality of life.
The treatable traits associated with the worst quality of life were having frequent chest infections, breathing pattern disorder, inadequate inhaler technique, high levels of inflammation in the blood, and depression. Receiving a statin for inflammation in the blood and oral corticosteroid for eosinophilic inflammation in the airway were associated with the largest improvements in quality of life. The results of this small study need to be repeated in larger studies to ensure they provide sound evidence for practice. This study is a starting place for a broader conversation about identifying treatable traits that have impact. This will help make sure that the treatable traits approach to airway disease management is feasible, cost-effective, and has the largest impact on the health of patients.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.