Treatable Traits is a new treatment paradigm proposed for the management of people with airway diseases. The treatment approach has been suggested as a way to progress precision or personalised medicine in COPD and asthma (Agusti 2017, Agusti 2016, McDonald 2019a). Patients are first assessed through a detailed clinical history and identification of airway disease risk factors (e.g. smoking history, history of allergies, occupational exposures, family history, respiratory disease in early life); spirometry and measures of airway inflammatory biomarkers, including exhaled nitric oxide fraction (FeNO) and blood eosinophils. These assessments will indicate a high or low probability of the presence of an airway disease (Agusti 2016).
Following this confirmation, it is recommended that each individual undergoes a multidimensional assessment to identify treatable traits and an individualised treatment plan is implemented based on the presence of traits.
In order to be considered a trait, the following criteria should be met. Traits should be identifiable using a trait identification marker, clinically relevant and modifiable (McDonald 2019a).
Traits are grouped into three domains – pulmonary and extrapulmonary traits and behaviours/risk-factors. While overall management according to treatable traits is a concept, the treatment of each individual trait is supported in most cases through RCT evidence. A systematic review of interventions targeting treatable traits in obstructive airways diseases found these interventions were effective in improving HRQoL and were also associated with small to medium reductions in hospitalizations, 1-year all-cause mortality, dyspnoea, anxiety, and depression (Sarwar 2022) [evidence level I]. Meta-analysis of the 4 COPD-only studies demonstrated a significant improvement in SGRQ -5.82 (95% CI -9.17 to -2.47).< Prev Next >