A Proposed Approach to Chronic Airway Disease (CAD) Using Therapeutic Goals and Treatable Traits: A Look to the Future

Int J Chron Obstruct Pulmon Dis. 2020 Sep 4:15:2091-2100. doi: 10.2147/COPD.S263430. eCollection 2020.

Abstract

Chronic airflow obstruction affects a wide range of airway diseases, the most frequent of which are asthma, COPD, and bronchiectasis; they are clearly identifiable in their extremes, but quite frequently overlap in some of their pathophysiological and clinical characteristics. This has generated the description of new mixed or overlapping disease phenotypes with no clear biological grounds. In this special article, a group of experts provides their perspective and proposes approaching the treatment of chronic airway disease (CAD) through the identification of a series of therapeutic goals (TG) linked to treatable traits (TT) - understood as clinical, physiological, or biological characteristics that are quantifiable using biomarkers. This therapeutic approach needs validating in a clinical trial with the strategy of identification of TG and treatment according to TT for each patient independently of their prior diagnosis.

Keywords: COPD asthma overlap; airflow obstruction; biomarker; personalised medicine.

MeSH terms

  • Airway Obstruction*
  • Asthma* / diagnosis
  • Asthma* / drug therapy
  • Goals
  • Humans
  • Phenotype
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / drug therapy