October 24, 2018
13 min read
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Patients with severe asthma have treatable traits

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Treatable traits were more often found in patients with severe asthma than those with non-severe asthma, according to findings recently published in Respirology.

“While the method of assessing treatable traits has been described, the assessment of treatable traits in other clinically relevant settings is unknown,” Vanessa M. McDonald, PhD, of the Centre of Excellence in Severe Asthma in Australia and colleagues wrote.

“It is not known whether severe asthma registries can be used to identify treatable traits in severe asthma, nor whether these traits are able to predict future risk of asthma attacks,” they added.

Researchers enrolled 434 patients with severe asthma in The Australasian Severe Asthma Web-Based Database — a study across 26 sites in Australia, New Zealand and Singapore that consisted of a cross-sectional evaluation of patient characteristics and a 2-year prospective cohort study. The 434 patients’ traits were compared to 102 patients with non-severe asthma.

McDonald and colleagues found patients with severe asthma had more pulmonary and extrapulmonary treatable traits than patients with non-severe asthma. Eleven traits were more common in patients with severe asthma: neutrophilic inflammation, obesity, systemic inflammation, inhaler device polypharmacy, depression, GERD, Aspergillus sensitization, being prone to exacerbation, incompletely reversible airflow limitation, vocal cord dysfunction and obstructive sleep apnea.

Researchers also identified traits that predicted exacerbations, which included eosinophilic inflammation, being prone to exacerbations, upper airway disease, obstructive sleep apnea, depression, anxiety, systemic inflammation, inhaler device polypharmacy, being underweight and vocal cord dysfunction

“Most of these traits are supported by evidence-based treatment recommendations. For some traits, however, such as systematic inflammation and neutrophilic airway inflammation, the evidence to support current treatment strategies is less developed,” McDonald and colleagues wrote.

“Similarly, there is also some debate about what is and is not a treatable trait, for example: ‘Is [airflow limitation] in severe asthma treatable?’ We propose that further international consensus is required to determine the accepted treatable traits and their biomarkers.” – by Janel Miller

Disclosure: The authors report no relevant financial disclosures.

 

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