Treatable Traits in Airway Disease: From Theory to Practice

Chronic airway diseases such as asthma and chronic obstructive pulmonary disease are prevalent and complex conditions that often coexist in the same patient. To address this complexity in clinical practice, and to move forward toward personalized and precision medicine of airway diseases, a strategy based on the identification and treatment of so-called treatable traits (TTs) has been proposed. A TT is a recognizable phenotypic or endotypic characteristic that can be assessed and successfully targeted by therapy to improve a clinical outcome in a patient with airway disease. Importantly, TTs can coexist in the same patient, so they are not mutually exclusive. The TT strategy proposes to investigate in each individual patient with chronic airway disease the number and type of TTs present and to treat each of them according to guideline recommendations. This strategy is agnostic (ie, independent) to the traditional diagnostic labels (asthma, chronic obstructive pulmonary disease), so it can be applied to any patient with airway disease. Currently, there is firm evidence supporting the adequacy and validity of the TT strategy. Here, we review the current state of the art of this topic, first by presenting its theoretical background and then by discussing how to best implement it in clinical practice. (c) 2023 American Academy of Allergy, Asthma & Immunology (J Allergy Clin Immunol Pract 2023;11:713-23)

Automated summary

Chronic airway diseases, such as asthma and chronic obstructive pulmonary disease, often coexist in the same patient. The treatable traits (TT) strategy, based on identifying and treating recognizable characteristics, aims to improve clinical outcomes. TTs can coexist and are not limited to specific diagnostic labels like asthma or COPD. There is solid evidence supporting the adequacy and validity of the TT strategy, and this review discusses the theoretical background and implementation in clinical practice.