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Treatable traits can be identified in a severe asthma registry and predict future exacerbations
Author(s) -
McDonald Vanessa M.,
Hiles Sarah A.,
Godbout Krystelle,
Harvey Erin S.,
Marks Guy B.,
Hew Mark,
Peters Matthew,
Bardin Philip G.,
Reynolds Paul N.,
Upham John W.,
Baraket Melissa,
Bhikoo Zaheerodin,
Bowden Jeffrey,
Brockway Ben,
Chung Li Ping,
Cochrane Belinda,
Foxley Gloria,
Garrett Jeffrey,
Jayaram Lata,
Jenkins Christine,
Katelaris Constance,
Katsoulotos Gregory,
Koh Mariko S.,
Kritikos Vicky,
Lambert Marina,
Langton David,
Lara Rivero Alexis,
Middleton Peter G.,
Nanguzgambo Aldoph,
Radhakrishghmeh,
Reddel Helen,
Rimmer Janet,
Southcott Anne Marie,
Sutherland Michael,
Thien Francis,
Wark Peter A.B.,
Yang Ian A.,
Yap Elaine,
Gibson Peter G.
Publication year - 2019
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.13389
Subject(s) - medicine , asthma , exacerbation , asthma exacerbations , inhaler , intensive care medicine , pediatrics
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.