Targeting Treatable Traits in Severe Asthma: A Randomised Controlled Trial.
Treatable traits have been proposed as a new paradigm for airway disease management.To characterise treatable traits in a severe asthma population and to determine the efficacy of targeting treatments to these treatable traits in severe asthma.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 endpoint.Participants with severe asthma had a mean (sd) of 10.44 (3.03) traits per person, comprising 3.01 (1.54) pulmonary, 4.85 (1.86) extrapulmonary and 2.58 (1.31) risk-factor/behavioural traits. 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).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 addresss the complexity of severe asthma.