Effectiveness of Interventions Targeting Treatable Traits for the Management of Obstructive Airway Diseases: A Systematic Review and Meta-Analysis

J Allergy Clin Immunol Pract. 2022 Sep;10(9):2333-2345.e21. doi: 10.1016/j.jaip.2022.05.012. Epub 2022 May 26.

Abstract

Background: The management of obstructive airway diseases (OADs) is complex. The treatable traits (TTs) approach may be an effective strategy for managing OADs.

Objective: To determine the effectiveness of interventions targeting TTs for managing OADs.

Methods: Ovid Embase, Medline, CENTRAL, and CINAHL Plus were searched from inception to March 9, 2022. Studies of interventions targeting at least 1 TT from pulmonary, extrapulmonary, and behavioral/lifestyle domains were included. Two reviewers independently extracted relevant data and performed risk-of-bias assessments. Meta-analyses were performed using random-effects models. Subgroup and sensitivity analyses were carried out to explore heterogeneity and to determine the effects of outlying studies.

Results: Eleven studies that used the TTs approach for OAD management were identified. Traits targeted within each study ranged from 13 to 36. Seven controlled trials were included in meta-analyses. TT interventions were effective at improving health-related quality of life (mean difference [MD] = -6.96, 95% CI: -9.92 to -4.01), hospitalizations (odds ratio [OR] = 0.52, 95% CI: 0.39 to 0.69), all-cause-1-year mortality (OR = 0.65, 95% CI: 0.45 to 0.95), dyspnea score (MD = -0.29, 95% CI: -0.46 to -0.12), anxiety (MD = -1.61, 95% CI: -2.92 to -0.30), and depression (MD = -2.00, 95% CI: -3.53 to -0.47).

Conclusion: Characterizing TTs and targeted interventions can improve outcomes in OADs, which offer a promising model of care for OADs.

Keywords: Asthma; Asthma-COPD overlap; Chronic obstructive pulmonary disease; Meta-analysis; Multidimensional assessment; Obstructive airway diseases; Treatable traits.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety
  • Dyspnea
  • Hospitalization
  • Humans
  • Pulmonary Disease, Chronic Obstructive*
  • Quality of Life*