CRE in Asthma Treatable Traits launched

Professor Vanessa McDonald

A Centre of Research Excellence in Asthma Treatable Traits (CREATT) has been established by the NHMRC at the University of Newcastle, NSW.

The centre os led by Professor Vanessa McDonald who along with Professor Peter Gibson and Professor John Upham bring their experience in the internationally-recognised CRE Severe Asthma to the new government-funded initiative.

CREATT was one of 14 new Centres of Research Excellence announced last month in a $35 million federal funding boost to improve health outcomes.

Professor McDonald told the limbic some of the key objectives of a CRE were to generate new knowledge, enhance multidisciplinary collaboration both nationally and internationally, translate new knowledge into practice, and train the next generation of health and medical research workforce.

“We have a batch of new investigators because our direction and research areas are quite different for this CRE,” she said.

She said treatable traits were inherently label free.

“So you confirm the patients have an airway disease whether that be asthma or COPD and you don’t get too caught up in the diagnosis. You look at the individual traits that are present in that person – usually through a multidimensional assessment – and once those traits are identified in that individual, you then do targeted therapies.”

“And a lot of the targeted therapies we are thinking about are evidence-based interventions. For example with eosinophilic airway inflammation, it’s monoclonal antibodies that target the IL-5 pathway. For airflow limitation, you’d treat with ICS and LABA.”

“But we are going beyond looking at the airway and looking at extrapulmonary domains and the risk factor and behavioural domains, and then looking at what this individual needs.”

She said some of the extrapulmonary treatable traits might include obstructive sleep apnoea, vocal cord dysfunction (VCD), or anxiety and depression.

“And there is a lot of work to be done around some of these traits,” she said.

For example: “We don’t know anything about the patient experience of VCD from a qualitative research sense … but we also don’t have really good validated multicomponent interventions that allow us to have nice diagnostic pathways for VCD and then effective interventions that can be applied outside of specialist severe asthma clinics.”

Speech pathologist Dr Anne Vertigan, an expert in vocal cord dysfunction, joins the CRE as one of the associate investigators.

Professor McDonald said another area of focus was physical activity. Although a lot of work had been done regarding physical activity in COPD, less work had been done in severe asthma. Physiotherapist and pulmonary rehab specialist Professor Anne Holland is another chief investigator on the team.

Obstetrician and gynaecologist Professor Michael Peek also joins the CRE to advance research into the management of asthma in pregnancy.

Professor McDonald said the CRE, which launched on 1 November, also has key partnerships with peak bodies such as the TSANZ and Asthma Australia.

While the NHMRC funding for the CRE in Severe Asthma finishes shortly, she said they had worked hard over the last five years to build a sustainable Centre of Excellence.

“It’s important for us as a group of investigators to maintain that presence where we are providing expert information to help manage severe asthma.”

“We will continue to develop resources, keep our toolkit up to date, and develop key meetings around severe asthma, etc. We will still have a face and continue as a CRE in Severe Asthma but we will now also focus research around our Centre of Research Excellence in Treatable Traits.”

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