Vanessa M McDonald1, Sarah A Hiles1, Krystelle Godbout2, Erin S Harvey1,3, Guy B Marks4,5, Mark Hew6, Matthew Peters7, Philip G Bardin8, Paul N Reynolds9,10, John W Upham11,12, Melissa Baraket13, Zaheerodin Bhikoo14, Jeffrey Bowden15, Ben Brockway16, Li Ping Chung17, Belinda Cochrane18,19, Gloria Foxley5, Jeffrey Garrett20, Lata Jayaram21,22, Christine Jenkins7,23,24,25, Constance Katelaris19,26, Gregory Katsoulotos27, Mariko S Koh28,29, Vicky Kritikos30,31, Marina Lambert32, David Langton33,34, Alexis Lara Rivero27, Peter G Middleton35,36,37, Aldoph Nanguzgambo32, Naghmeh Radhakrishna6, Helen Reddel31, Janet Rimmer5,38, Anne Marie Southcott22, Michael Sutherland39, Francis Thien40, Peter A B Wark1,3, Ian A Yang41,42, Elaine Yap20, Peter G Gibson1,3. 1. Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia. 2. Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC, Canada. 3. Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia. 4. South Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, Australia. 5. Woolcock Institute of Medical Research, The University of Sydney, Glebe, NSW, Australia. 6. Difficult Asthma Clinic, Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, VIC, Australia. 7. Department of Thoracic Medicine, Concord Hospital, Concord, NSW, Australia. 8. Lung and Sleep Medicine, Monash University and Medical Centre, Clayton, VIC, Australia. 9. Department of Lung Research, Hanson Institute, Adelaide, SA, Australia. 10. Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia. 11. The University of Queensland Diamantina Institute, Woolloongabba, QLD, Australia. 12. Department of Respiratory Medicine, Princess Alexandra Hospital, Woolloongabba, QLD, Australia. 13. Department of Respiratory Medicine, Liverpool Hospital and School of Medicine, UNSW Sydney, Liverpool, NSW, Australia. 14. Respiratory Department, Waikato Hospital, Hamilton, New Zealand. 15. Department of Respiratory, Allergy and Sleep Medicine, Flinders Medical Centre, Bedford Park, SA, Australia. 16. Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. 17. Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia. 18. Department of Respiratory and Sleep Medicine, Campbelltown Hospital, Campbelltown, NSW, Australia. 19. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia. 20. Respiratory Department, Middlemore Hospital, Auckland, New Zealand. 21. Department of Medicine, Melbourne Clinical School, University of Melbourne, Melbourne, VIC, Australia. 22. Department of Respiratory and Sleep Disorders Medicine, Western Health, Footscray, VIC, Australia. 23. Concord Clinical School and Respiratory Discipline, University of Sydney, Concord, NSW, Australia. 24. Respiratory Group, The George Institute for Global Health, Newtown, NSW, Australia. 25. Respiratory Medicine, UNSW Sydney, Liverpool, NSW, Australia. 26. Immunology Department, Campbelltown Hospital, Campbelltown, NSW, Australia. 27. St George Specialist Centre, Kogarah, NSW, Australia. 28. Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore. 29. Duke - National University Singapore Medical School, Singapore. 30. Woolcock Institute of Medical Research, Quality Use of Respiratory Medicines, The University of Sydney, Glebe, NSW, Australia. 31. Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. 32. Respiratory Services, MidCentral Health, Palmerston North Hospital, Palmerston North, New Zealand. 33. Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia. 34. Department of Thoracic Medicine, Frankston Hospital, Frankston, VIC, Australia. 35. Sydney Medical School, University of Sydney, Camperdown, NSW, Australia. 36. Ludwig Engel Centre for Respiratory Research, Westmead Institute of Medical Research, Westmead, NSW, Australia. 37. Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, NSW, Australia. 38. Thoracic Medicine, St Vincent's Clinic, Darlinghurst, NSW, Australia. 39. Department of Respiratory and Sleep Medicine, Austin Hospital, Heidelberg, VIC, Australia. 40. Department of Respiratory Medicine, Eastern Health and Monash University, Box Hill, VIC, Australia. 41. The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside West, QLD, Australia. 42. UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, QLD, Australia.
Abstract
BACKGROUND AND OBJECTIVE: A new taxonomic and management approach, termed treatable traits, has been proposed for airway diseases including severe asthma. This study examined whether treatable traits could be identified using registry data and whether particular treatable traits were associated with future exacerbation risk. METHODS: The Australasian Severe Asthma Web-Based Database (SAWD) enrolled 434 participants with severe asthma and a comparison group of 102 participants with non-severe asthma. Published treatable traits were mapped to registry data fields and their prevalence was described. Participants were characterized at baseline and every 6 months for 24 months. RESULTS: In SAWD, 24 treatable traits were identified in three domains: pulmonary, extrapulmonary and behavioural/risk factors. Patients with severe asthma expressed more pulmonary and extrapulmonary treatable traits than non-severe asthma. Allergic sensitization, upper-airway disease, airflow limitation, eosinophilic inflammation and frequent exacerbations were common in severe asthma. Ten traits predicted exacerbation risk; among the strongest were being prone to exacerbations, depression, inhaler device polypharmacy, vocal cord dysfunction and obstructive sleep apnoea. CONCLUSION: Treatable traits can be assessed using a severe asthma registry. In severe asthma, patients express more treatable traits than non-severe asthma. Traits may be associated with future asthma exacerbation risk demonstrating the clinical utility of assessing treatable traits.
BACKGROUND AND OBJECTIVE: A new taxonomic and management approach, termed treatable traits, has been proposed for airway diseases including severe asthma. This study examined whether treatable traits could be identified using registry data and whether particular treatable traits were associated with future exacerbation risk. METHODS: The Australasian Severe Asthma Web-Based Database (SAWD) enrolled 434 participants with severe asthma and a comparison group of 102 participants with non-severe asthma. Published treatable traits were mapped to registry data fields and their prevalence was described. Participants were characterized at baseline and every 6 months for 24 months. RESULTS: In SAWD, 24 treatable traits were identified in three domains: pulmonary, extrapulmonary and behavioural/risk factors. Patients with severe asthma expressed more pulmonary and extrapulmonary treatable traits than non-severe asthma. Allergic sensitization, upper-airway disease, airflow limitation, eosinophilic inflammation and frequent exacerbations were common in severe asthma. Ten traits predicted exacerbation risk; among the strongest were being prone to exacerbations, depression, inhaler device polypharmacy, vocal cord dysfunction and obstructive sleep apnoea. CONCLUSION: Treatable traits can be assessed using a severe asthma registry. In severe asthma, patients express more treatable traits than non-severe asthma. Traits may be associated with future asthma exacerbation risk demonstrating the clinical utility of assessing treatable traits.
Authors: Xin Zhang; Ke Deng; Yulai Yuan; Lei Liu; Shuwen Zhang; Changyong Wang; Gang Wang; Hongping Zhang; Lei Wang; Gaiping Cheng; Lisa G Wood; Gang Wang Journal: Nutrients Date: 2022-06-17 Impact factor: 6.706
Authors: Kerry L Hancock; Sinthia Bosnic-Anticevich; John D Blakey; Mark Hew; Li Ping Chung; Biljana Cvetkovski; Scott Claxton; Peter Del Fante; Eve Denton; Joe Doan; Kanchanamala Ranasinghe; Lucy Morgan; Anita Sharma; Peter K Smith; Deb Stewart; Philip J Thompson; Russell Wiseman; John W Upham; Kwok Y Yan; Victoria Carter; Kiranjeet Dhillon; Florian Heraud; Thao Le; Rebecca Vella; David Price Journal: Pragmat Obs Res Date: 2022-07-05
Authors: John Blakey; Li Ping Chung; Vanessa M McDonald; Laurence Ruane; John Gornall; Chris Barton; Sinthia Bosnic-Anticevich; John Harrington; Mark Hew; Anne E Holland; Trudy Hopkins; Lata Jayaram; Helen Reddel; John W Upham; Peter G Gibson; Philip Bardin Journal: Respirology Date: 2021-09-29 Impact factor: 6.175
Authors: Emmely W de Roos; Lies Lahousse; Katia M C Verhamme; Gert-Jan Braunstahl; Johannes J C C M In 't Veen; Bruno H Stricker; Guy G O Brusselle Journal: ERJ Open Res Date: 2021-07-12