There are five ‘treatable traits’ in chronic airways disease that have a major impact on patient quality of life, according to an Australian study.
Researchers at the Newcastle University, NSW, analysed the results from two local trials of treatment targeted at treatable traits in COPD and asthma to find which had the strongest associations with health-related quality of life.
Of the 22 potential treatable traits assessed, they found that five had a strong association with quality of life as measured by the St George Respiratory Questionnaire (SGRQ):
- Frequent chest infections,
- Dysfunctional breathing/breathing pattern disorder,
- Inadequate inhaler technique,
- Systemic inflammation ,
- Airway pathogen colonisation.
The analysis also found that statin treatment of systemic inflammation (as defined by CRP>3mg/L) and corticosteroid treatment of eosinophilic airway inflammation were associated with the greatest improvements in patient quality of life.
The researchers noted that some other traits, such as exercise intolerance, anxiety, and obesity were associated with smaller improvements in quality of life.
The findings come from a retrospective review of two trials involving 91 patients with COPD or severe asthma, which lasted 12-16 weeks, and were conducted at the Department of Respiratory and Sleep Medicine, John Hunter Hospital.
Overall, both trials found that the interventions tarted at treatable traits led to a large, significant improvement in quality of life as compared with usual care.
The researchers said their aim was to identify which treatable traits would have most clinical impact from the patient’s perspective.
They said there were several possible reasons why some treatable traits had greater associations with outcomes than others, including the availability of effective treatments, and some being more responsive to treatment than others.
“For instance, neutrophilic airway inflammation, although it has been shown to be related to important patient outcomes such as exacerbation, there are not specific targeted treatments available for this trait,” they wrote in the Journal of Allergy and Clinical Immunology: In Practice.
And some treatable traits related to lifestyle – such as obesity – may take a long time to respond to treatment and have an effect on quality of life, they added.
“This study is a starting place for a broader conversation regarding identifying treatable traits that have impact, to derive a model of care that is feasible, cost-effective and has the largest impact on patient outcomes,” they concluded.