Treatable traits in the European U‐BIOPRED adult asthma cohorts

Biomarkers for diagnosis and prediction of therapy responses in allergic diseases and asthma

“…Although generally based on increased sputum neutrophils or absence of normal levels of (sputum) eosinophils and neutrophils (paucigranulocytic) with normal levels of other Type 2 markers, the diagnosis of non-Type 2 asthma is difficult to establish as often based on cross-sectional data potentially affected by confounders including respiratory infections or anti-inflammatory therapies. 41 In the absence of targeted biologicals, in non-Type 2 asthma treatable traits should be targeted, [46][47][48] e.g, obesity, smoking habits, psychological aspects, neutrophilia as a potential indicator of respiratory infection and airway narrowing or airway hyperresponsiveness as an indicator of ASM dysfunction, while corticosteroids may not be effective and should be tapered off ( Figure 1). 23 In conclusion, despite substantial progress in our understanding, applicable biomarkers and targeted treatment options for Type 2 asthma, further characterization of molecular pathways by omics technologies, 49-51 sophisticated imaging 52 and innovative anatomical approaches 53 should help to further unravel the complexity of asthma and to define reliable (composite) biomarkers and therapeutic strategies for patients nonresponsive to currently available (targeted) treatment options including non-Type 2 asthma.…”

Precision medicine for the discovery of treatable mechanisms in severe asthma

“…In addition, the definition of a treatable trait is too imprecise to be useful to the individual patient with chronic obstructive lung disease . Indeed, twenty‐three treatable traits were identified in the U‐BIOPRED severe asthma cohort, including seven pulmonary, 11 extra‐pulmonary and five behavioural/psychosocial treatable traits . Seven out of the ten most prevalent traits in severe asthma were classed as pulmonary treatable traits, while the most prevalent extra‐pulmonary traits were atopy, rhinosinusitis, obesity, reflux and obstructive sleep apnoea.…”

Evaluation and Management of Difficult-to-Treat and Severe Asthma: An Expert Opinion From the Korean Academy of Asthma, Allergy and Clinical Immunology, the Working Group on Severe Asthma

“…Recently, there has been a move away from the labeling of airway diseases and toward the identification of phenotypic “treatable traits,” linking them to therapeutic approaches. 30 These traits can be treatable based on phenotypic recognition or deep understanding of the critical endotype recognition. 31 A treatable trait must be clinically important, should be able to be effectively treated to be called a “treatable” trait, and needs a trait identification marker for objectively identifying the presence of the trait in preparation for targeted therapy ( Table 4 ).…”

“… 31 A treatable trait must be clinically important, should be able to be effectively treated to be called a “treatable” trait, and needs a trait identification marker for objectively identifying the presence of the trait in preparation for targeted therapy ( Table 4 ). 30 As an example, a recent study examined 24 treatable traits of SA across 3 domains (pulmonary, extra-pulmonary, and behavioral/risk factors). This revealed 10 treatable traits, including depression and inhaler-device polypharmacy, that were significantly associated with an elevated risk of future asthma exacerbations.…”