Vanessa M McDonald1,2,3,4,5, Vanessa L Clark6,2,3,5, Laura Cordova-Rivera6,2,3, Peter A B Wark6,2,3,4, Katherine J Baines6,2,3, Peter G Gibson6,2,3,4. 1. National Health and Medical Research Council, Centre of Excellence in Severe Asthma, Newcastle, Australia Vanessa.McDonald@newcastle.edu.au. 2. Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, Australia. 3. Hunter Medical Research Institute, Newcastle, Australia. 4. Dept of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia. 5. School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia. 6. National Health and Medical Research Council, Centre of Excellence in Severe Asthma, Newcastle, Australia.
Abstract
RATIONALE: Treatable traits have been proposed as a new paradigm for airway disease management. OBJECTIVES: To characterise treatable traits in a severe asthma population and to determine the efficacy of targeting treatments to these treatable traits in severe asthma. METHODS:Participants (n=140) with severe asthma were recruited to a cross-sectional study and underwent a multidimensional assessment to characterise treatable traits. Eligible participants with severe asthma (n=55) participated in a 16-week parallel-group randomised controlled trial to determine the feasibility and efficacy of management targeted to predefined treatable traits, compared to usual care in a severe asthma clinic. The patient-reported outcome of health-related quality of life was the trial's primary end-point. MAIN RESULTS:Participants with severe asthma had a mean±sd of 10.44±3.03 traits per person, comprising 3.01±1.54 pulmonary and 4.85±1.86 extrapulmonary traits and 2.58±1.31 behavioural/risk factors. Individualised treatment that targeted the traits was feasible and led to significantly improved health-related quality of life (0.86 units, p<0.001) and asthma control (0.73, p=0.01). CONCLUSIONS: Multidimensional assessment enables detection of treatable traits and identifies a significant trait burden in severe asthma. Targeting these treatable traits using a personalised-medicine approach in severe asthma leads to improvements in health-related quality of life, asthma control and reduced primary care acute visits. Treatable traits may be an effective way to address the complexity of severe asthma.
RCT Entities:
RATIONALE: Treatable traits have been proposed as a new paradigm for airway disease management. OBJECTIVES: To characterise treatable traits in a severe asthma population and to determine the efficacy of targeting treatments to these treatable traits in severe asthma. METHODS:Participants (n=140) with severe asthma were recruited to a cross-sectional study and underwent a multidimensional assessment to characterise treatable traits. Eligible participants with severe asthma (n=55) participated in a 16-week parallel-group randomised controlled trial to determine the feasibility and efficacy of management targeted to predefined treatable traits, compared to usual care in a severe asthma clinic. The patient-reported outcome of health-related quality of life was the trial's primary end-point. MAIN RESULTS:Participants with severe asthma had a mean±sd of 10.44±3.03 traits per person, comprising 3.01±1.54 pulmonary and 4.85±1.86 extrapulmonary traits and 2.58±1.31 behavioural/risk factors. Individualised treatment that targeted the traits was feasible and led to significantly improved health-related quality of life (0.86 units, p<0.001) and asthma control (0.73, p=0.01). CONCLUSIONS: Multidimensional assessment enables detection of treatable traits and identifies a significant trait burden in severe asthma. Targeting these treatable traits using a personalised-medicine approach in severe asthma leads to improvements in health-related quality of life, asthma control and reduced primary care acute visits. Treatable traits may be an effective way to address the complexity of severe asthma.
Authors: Zoran Stojanovic; Filipe Gonçalves-Carvalho; Alicia Marín; Jorge Abad Capa; Jose Domínguez; Irene Latorre; Alicia Lacoma; Cristina Prat-Aymerich Journal: ERJ Open Res Date: 2022-09-12
Authors: Eleanor C Majellano; Vanessa L Clark; Rebecca F McLoughlin; Peter G Gibson; Vanessa M McDonald Journal: PLoS One Date: 2022-06-07 Impact factor: 3.752
Authors: Natasha A Winter; Peter G Gibson; Michael Fricker; Jodie L Simpson; Peter A Wark; Vanessa M McDonald Journal: Allergy Asthma Immunol Res Date: 2021-05 Impact factor: 5.764
Authors: Alex J van 't Hul; Eleonore H Koolen; Jeanine C Antons; Marianne de Man; Remco S Djamin; Johannes C C M In 't Veen; Sami O Simons; Michel van den Heuvel; Bram van den Borst; Martijn A Spruit Journal: ERJ Open Res Date: 2020-11-02