Treatable traits in acute exacerbations of chronic airway diseases

Abstract

Acute exacerbations of chronic airway disease are common occurrences that cause a major burden of illness. Acute exacerbations are associated with impaired health status, increased lung function decline, hospitalization and increased risk of death. Exacerbation avoidance is a major priority. Despite this goal, exacerbations continue to occur and the need for effective models of care that optimize patient outcomes are urgently needed. ‘Treatable Traits’ is an approach to personalized medicine that has been proposed for the management of airway diseases. The treatable traits approach allows for the recognition of clinically important, identifiable and treatable disease characteristics, followed by targeted and individualized treatment interventions to address each trait. We review the literature relating to treatable traits in airway diseases; in particular, those traits that can predict exacerbations and approaches to management that aim to prevent exacerbations by using a treatable traits model of care. We propose this approach as a potentially useful model of care to both prevent and manage acute exacerbations.

Diagnosis, prevalence, and clinical impact of sarcopenia in COPD: a systematic review and meta‐analysis

“…Sarcopenia has, however, been highlighted as an important 'treatable trait' in adult respiratory medicine. 59 One of the few studies to explore this area was conducted by Jones et al 2 who demonstrated that pulmonary rehabilitation, a comprehensive, multicomponent exercise-based intervention, improved a range of clinical outcomes and reduced the incidence of sarcopenia in a cohort of patients with COPD. More research is clearly warranted to further validate the findings of Jones and colleagues, including the use of other recommended adjunctive therapies such as nutritional supplementation.…”

“…This systematic review has highlighted the clinical relevance of including measurements of muscle mass, muscle strength, and physical performance in individuals with COPD, as these variables clearly associate with sarcopenia, exacerbations, and poor prognosis. 47,59 The more widespread implementation of these measures in clinical practice could help identify patients with COPD at increased risk of future healthcare use related to exacerbations. 47,65 This is also an important priority from a public health economic perspective.…”

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

“…One study of sputum NE activity in a large population of adults with bronchiectasis found an association of increased activity and future risk of exacerbation, offering the promise of an easily-obtainable bio-marker for clinical surveillance (24,114). There is robust research presently underway to identify clinical phenotypes and so-called "treatable traits" in non-CF bronchiectasis, which will one day permit more precise and tailored management strategies (115,116).…”

COVID‐19 rehabilitation delivered via a telehealth pulmonary rehabilitation model: a case series

“…The COVID-19 telehealth rehabilitation programme consisted of (1) a comprehensive initial rehabilitation assessment with a physiotherapist for identification of symptoms and physical impairments that were considered treatable (i.e. treatable traits) [7] within the PR context [8];…”