Treatable Traits in Elderly Asthmatics from the Australasian Severe Asthma Network: A Prospective Cohort Study

Wu, Wen Wen; Zhang, Xin; Li, Min; Liu, Ying; Chen, Zhi Hong; Xie, Min; Zhao, Shu Zhen; Wang, Gang; Zhang, Hong Ping; Wang, Ting; Qin, Ling; Wang, Lei; Oliver, Brian G.; Wan, Hua Jing; Zhang, Jie; McDonald, Vanessa M.; Marks, Guy B.; Li, Wei Min; Birring, Surinder S.; Gibson, Péter G.

doi:10.1016/j.jaip.2021.03.042

Cited by 24 publications

(20 citation statements)

References 48 publications

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“…Worsening lung function and comorbidities (such as depression and chronic lung diseases) are two independent risk factors for asthmatic exacerbations [1]. In recent years, treatable traits have been regarded as a new paradigm for asthma management, with one key paradigm involving the early identification of pulmonary, extrapulmonary, and behavioral/risk factors related to asthmatic exacerbations [2][3][4][5]. A recent study demonstrated that targeting treatable traits may reduce acute exacerbations, and improve the quality of life and asthma control in individuals with severe asthma [2].…”

Section: Introductionmentioning

confidence: 99%

Associations between sarcopenia with asthmatic prevalence, lung function and comorbidity

Tian

Song

et al. 2022

BMC Geriatr

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Background Sarcopenia is listed as a treatment trait in behavioral/risk factors for severe asthma, but studies on asthma and sarcopenia are lacking. This study aimed to determine the associations between sarcopenia with asthmatic prevalence, symptoms, lung function and comorbidities. Methods Fifteen thousand four hundred four individuals from the China Health and Retirement Longitudinal Study(CHARLS) and 10,263 individuals from the Study on global AGEing and adult health(SAGE) in China were included in this study. Four components of this study were used to assess the bidirectional association in the prevalence between sarcopenia with asthma, and estimate the relationships between sarcopenia with asthmatic symptoms, lung function and comorbidities via generalized additive models. The 10-item Center for Epidemiological Studies–Depression Scale ≥ 12 scores was classified as depression. Results In the CHARLS and SAGE, the prevalence of sarcopenia in asthmatics was higher than those without asthma. Asthmatics with sarcopenia had a significantly increased prevalence of severe shortness of breath(sarcopenia yes vs. no, adjusted OR = 3.71, 95%CI: 1.43–9.60) and airway obstruction in the SAGE(sarcopenia yes vs. no, adjusted OR = 6.82, 95%CI: 2.54–18.34) and an obvious reduction of PEF in the CHARLS and SAGE(sarcopenia yes vs. no, adjusted RR = 0.86, 95%CI: 0.82–0.91) compared to asthmatics without sarcopenia. The presence of sarcopenia was positively associated with the prevalence of chronic obstructive pulmonary disease(sarcopenia yes vs no, adjusted OR = 5.76, 95%CI:2.01–16.5) and depression(sarcopenia yes vs no, adjusted OR = 1.87, 95%CI:1.11–3.14) in asthmatics. Conclusions Our findings indicated that sarcopenia partakes in the development of asthma by affecting lung function and comorbidities and maybe considered a treatable trait of asthma management.

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Section: Introductionmentioning

confidence: 99%

Associations between sarcopenia with asthmatic prevalence, lung function and comorbidity

Tian

Song

et al. 2022

BMC Geriatr

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“…Sixteen (64%) studies were conducted in the US. There was a single study from each of the United Kingdom, 22 Sweden, 21 New Zealand, 38 Netherlands, 29 Japan, 32 China, 24 Canada, 20 and Belgium. 27 One study 30 was a secondary analysis of three multinational clinical studies, conducted across several different regions, including South Africa, Germany, Canada, France, Australia, the United Kingdom, Spain, and Sweden.…”

Section: Resultsmentioning

confidence: 99%

Primary Care Asthma Attack Prediction Models for Adults: A Systematic Review of Reported Methodologies and Outcomes

Ma,

Tibble

2024

JAA

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Prognostic models hold great potential for predicting asthma exacerbations, providing opportunities for early intervention, and are a popular area of current research. However, it is unclear how models should be compared and contrasted, given their differences in both design and performance, particularly with a view to potential implementation in routine practice. This systematic review aimed to identify novel predictive models of asthma attacks in adults and compare differences in construction related to populations, outcome definitions, prediction time horizons, algorithms, validation, and performance estimation. Twenty-five studies were identified for comparison, with varying definitions of asthma attacks and prediction event time horizons ranging from 15 days to 30 months. The most commonly used algorithm was logistic regression (20/25 studies); however, none of the six which tested multiple algorithms identified it as highest performing algorithm. The effect of various study design characteristics on performance was evaluated in order to provide context to the limitations of highly performing models. Models used a variety of constructs, which affected both their performance and their viability for implementation in routine practice. Consultation with stakeholders is necessary to identify priorities for model refinement and to create a benchmark of acceptable performance for implementation in clinical practice.

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“…In Australian cohorts, approximately 20–30 potentially treatable traits were evaluated. 66 67 70 Based on anatomic locations, treatable traits can be classified into 3 domains, including respiratory, extra-respiratory and behavioral domains; each domain is composed of several traits ( Fig. 2 ).…”

Section: The Concept Of Treatable Traits In Severe Asthmamentioning

confidence: 99%

“…Furthermore, it is important to address patients’ needs and to consider resource availability and cost effectiveness in developing treatable trait-based healthcare models in each region. However, based on previous studies, a number of traits are expected to be associated with clinical outcomes such as exacerbations or OCS use 66 68 70 ; subsequently, the demonstration of treatment potential (or RCTs confirming targeted treatments) will be a critical determining step. Currently, only a few traits have robust clinical evidence: T2-related inflammation (corticosteroids and T2 biologics), airflow obstruction (bronchodilators), and smoking (smoking cessation).…”

Section: The Concept Of Treatable Traits In Severe Asthmamentioning

confidence: 99%

Evolving Concept of Severe Asthma: Transition From Diagnosis to Treatable Traits

Park

Kang

Song

et al. 2022

Allergy Asthma Immunol Res

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In recent decades, the concept of severe asthma has evolved from an umbrella term encompassing patients with high-intensity treatment needs to a clinical syndrome with heterogeneous, albeit distinct, pathophysiological processes. Biased and unbiased cluster approaches have been used to identify several clinical phenotypes. In parallel, cellular and molecular approaches allow for the development of biological therapies, especially targeting type 2 (T2) cytokine pathways. Although T2-biologics have significantly improved clinical outcomes for patients with severe asthma in real-world practice, questions on the proper use of biologics remain open. Furthermore, a subset of severe asthma patients remains poorly controlled. The unmet needs require a new approach. The “treatable traits” concept has been suggested to address a diversity of pathophysiological factors in severe asthma and overcome the limitations of existing treatment strategies. With a tailored therapy that targets the treatable traits in individual patients, better personalized medical care and outcomes should be achieved.

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Treatable Traits in Elderly Asthmatics from the Australasian Severe Asthma Network: A Prospective Cohort Study

Cited by 24 publications

References 48 publications

Associations between sarcopenia with asthmatic prevalence, lung function and comorbidity

Associations between sarcopenia with asthmatic prevalence, lung function and comorbidity

Primary Care Asthma Attack Prediction Models for Adults: A Systematic Review of Reported Methodologies and Outcomes

Evolving Concept of Severe Asthma: Transition From Diagnosis to Treatable Traits

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