Moving towards a Treatable Traits model of care for the management of obstructive airways diseases. (October 2021)

• Record Type: Journal Article
• Authors: Agusti, Alvar; Barnes, Neil; Cruz, Alvaro A.; Gibson, Peter G.; Heaney, Liam G.; Inoue, Hiromasa; Leather, David; Martinez, Fernando J.; McDonald, Vanessa M.; Oppenheimer, John; Papi, Alberto; Pavord, Ian D.; Thomas, Mike; Walker, Samantha; Yates, Louisa
• Is Part Of: Respiratory medicine. Volume 187(2021)
• Publication Date: 2021-10
• Subjects: Asthma -- Biomarkers -- COPD -- Targeted therapy; CO carbon monoxide -- COPD chronic obstructive pulmonary disease -- CT computerized tomography -- DLCO diffusing capacity of carbon monoxide -- FeNO fractional exhaled nitric oxide -- GOLD Global Initiative for Chronic Obstructive Lung Disease -- ICS inhaled corticosteroid -- IL interleukin -- IRR incidence rate ratio -- LABA long-acting β-2 adrenergic bronchodilator -- OCS oral corticosteroid -- RCT randomized controlled trial -- SpO2 saturation of peripheral oxygen -- TT Treatable Traits; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2021.106572
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent chronic airways diseases. Both are complex and heterogeneous. Traditionally, clinical guidelines have advocated a stepwise approach to pharmacotherapy of asthma and COPD, but there is increasing realization that both require a more personalized and precise management approach. To this end, a management strategy based on the so-called Treatable Traits has been proposed. Emerging evidence suggests that this model improves relevant outcomes in patients with chronic airway diseases but further research is needed to guide implementation. This review discusses the challenges, opportunities, and hurdles that its implementation will have to face. Graphical abstract: Image 1 Highlights: The complexity and variability of airways diseases supports personalized treatment. A Treatable Traits (TT) model targeting measurable/treatable traits has been proposed. The TT model factors in variability and causes of airways diseases between patients. TT also addresses symptoms in pulmonary, non-pulmonary, behavioural/lifestyle areas. Evidence suggests a TT model of care will work; more study will guide implementation.