Add like
Add dislike
Add to saved papers

Trait profiles in difficult-to-treat asthma: clinical impact and response to systematic assessment.

Allergy 2023 March 21
BACKGROUND: Multidisciplinary systematic assessment improves outcomes in difficult-to-treat asthma, but without clear response predictors. Using a treatable-traits framework, we stratified patients by trait profile, examining clinical impact and treatment responsiveness to systematic assessment.

METHODS: We performed latent class analysis using 12 traits on difficult-to-treat asthma patients undergoing systematic assessment at our institution. We examined Asthma Control Questionnaire (ACQ-6) and Asthma Quality of Life Questionnaire (AQLQ) scores, FEV1 , exacerbation frequency, and maintenance oral corticosteroid (mOCS) dose, at baseline and following systematic assessment.

RESULTS: Among 241 patients; two airway-centric profiles were characterised by early-onset with allergic rhinitis (n=46) and adult-onset with eosinophilia/chronic rhino-sinusitis (n=60)), respectively, with minimal comorbid or psychosocial traits; three non-airway centric profiles exhibited either comorbid (obesity, vocal cord dysfunction, dysfunctional breathing) dominance (n=51), psychosocial (anxiety, depression, smoking, unemployment) dominance (n=72), or multi-domain impairment (n=12). Compared to airway-centric profiles, non-airway centric profiles had worse baseline ACQ-6 (2.7 vs 2.2, p<0.001) and AQLQ (3.8 vs 4.5, p<0.001) scores. Following systematic assessment, the cohort showed overall improvements across all outcomes. However, airway-centric profiles had more FEV1 improvement (5.6% vs 2.2% predicted, p<0.05) while non-airway centric profiles trended to greater exacerbation reduction (1.7 vs 1.0, p=0.07); mOCS dose reduction was similar (3.1mg vs 3.5mg, p=0.782).

CONCLUSION: Distinct trait profiles in difficult-to-treat asthma are associated with different clinical outcomes and treatment responsiveness to systematic assessment. These findings yield clinical and mechanistic insights into difficult-to-treat asthma, offer a conceptual framework to address disease heterogeneity, and highlight areas responsive to targeted intervention.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app