Càtedra Salut Respiratoria, Universitat Barcelona, Barcelona, Spain.
Servei Pneumologia, Respiratory Institute, Hospital Clinic, Barcelona, Spain.
Respirology. 2022 Nov;27(11):929-940. doi: 10.1111/resp.14325. Epub 2022 Jul 21.
Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent and complex diseases that require personalized management. Although a strategy based on treatable traits (TTs) has been proposed, the prevalence and relationship of TTs to the diagnostic label and disease severity established by the attending physician in a real-world setting are unknown. We assessed how the presence/absence of specific TTs relate to the diagnosis and severity of 'asthma', 'COPD' or 'asthma + COPD'.
The authors selected 30 frequently occurring TTs from the NOVELTY study cohort (NOVEL observational longiTudinal studY; NCT02760329), a large (n = 11,226), global study that systematically collects data in a real-world setting, both in primary care clinics and specialized centres, for patients with 'asthma' (n = 5932, 52.8%), 'COPD' (n = 3898, 34.7%) or both ('asthma + COPD'; n = 1396, 12.4%).
The results indicate that (1) the prevalence of the 30 TTs evaluated varied widely, with a mean ± SD of 4.6 ± 2.6, 5.4 ± 2.6 and 6.4 ± 2.8 TTs/patient in those with 'asthma', 'COPD' and 'asthma + COPD', respectively (p < 0.0001); (2) there were no large global geographical variations, but the prevalence of TTs was different in primary versus specialized clinics; (3) several TTs were specific to the diagnosis and severity of disease, but many were not; and (4) both the presence and absence of TTs formed a pattern that is recognized by clinicians to establish a diagnosis and grade its severity.
These results provide the largest and most granular characterization of TTs in patients with airway diseases in a real-world setting to date.
哮喘和慢性阻塞性肺疾病（COPD）是两种常见且复杂的疾病，需要进行个性化管理。尽管已经提出了一种基于可治疗特征（TTs）的策略，但在真实环境中，这些 TTs 的流行程度及其与主治医生所确定的诊断标签和疾病严重程度的关系尚不清楚。我们评估了特定 TTs 的存在/缺失与“哮喘”、“COPD”或“哮喘+COPD”的诊断和严重程度之间的关系。
作者从 NOVELTY 研究队列（NOVEL 观察性纵向研究；NCT02760329）中选择了 30 个常见的 TTs，这是一项大型（n=11226）的全球性研究，在初级保健诊所和专门中心中系统地收集了“哮喘”（n=5932，52.8%）、“COPD”（n=3898，34.7%）或两者（n=1396，12.4%）患者的真实数据。
结果表明：（1）评估的 30 个 TTs 的患病率差异很大，“哮喘”、“COPD”和“哮喘+COPD”患者的平均（±标准差）分别为 4.6±2.6、5.4±2.6 和 6.4±2.8 个 TTs/患者（p<0.0001）；（2）全球不存在大的地域差异，但初级诊所与专科诊所的 TTs 患病率不同；（3）许多 TTs 与疾病的诊断和严重程度相关，但也有许多不相关；（4）TTs 的存在和缺失形成了一种模式，被临床医生用于建立诊断并对其严重程度进行分级。
这些结果提供了迄今为止在真实环境中对气道疾病患者 TTs 的最大和最详细的特征描述。
