Abstract
Interstitial lung disease (ILD) is a diverse group of inflammatory and fibrotic lung conditions causing significant morbidity and mortality. A multitude of factors beyond the lungs influence symptoms, health-related quality of life, disease progression, and survival in patients with ILD. Despite an increasing emphasis on multidisciplinary management in ILD, the absence of a framework for assessment and delivery of comprehensive patient care poses challenges in clinical practice. The treatable traits approach is a precision medicine care model that operates on the premise of individualised multidimensional assessment for distinct traits that can be targeted by specific interventions. The potential utility of this approach has been described in airway diseases but has not been adequately considered in ILD. Given the similar disease heterogeneity and complexity between ILD and airway diseases, we explore the concept and potential application of the treatable traits approach in ILD. A framework of aetiological, pulmonary, extra-pulmonary, and behavioural and lifestyle treatable traits relevant to clinical care and outcomes for patients with ILD is proposed. We further describe key research directions to evaluate the application of the treatable traits approach towards advancing patient care and health outcomes in ILD.
Footnotes
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Conflict of interest: Vincent Cottin reports unrestricted grant from Boehringer Ingelheim to institution, outside the submitted work; Consulting fees from Astra Zeneca, Boehringer Ingelheim, Celgene / BMS, CSL Behring, Ferrer / United Therapeutics, GSK, Pliant, Pure Tech, RedX, Roche, Sanofi, and Shionogi, outside the submitted work; Fees for lectures and consulting from Boehringer Ingelheim, Ferrer / United Therapeutics, and Roche, outside the submitted work; Support for attending meetings from Boehringer Ingelheim, and Roche, outside the submitted work; Data and safety monitoring board for Galapagos, and Galecto, outside the submitted work; Adjudication committee for Fibrogen, outside the submitted work.
Conflict of interest: Elisabetta A Renzoni reports Boeringher Ingelheim research grant made to my institution, outside the submitted work; Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Boeringher Ingelheim, Roche, and Chiesi, outside the submitted work; support for attending meetings and/or travel from Boeringher Ingelheim, outside the submitted work; Advisory boards for Boeringher Ingelheim, and Roche, outside the submitted work.
Conflict of interest: Mary Strek reports grants or contracts from Boehringer Ingelheim, and Pulmonary Fibrosis Foundation, outside the submitted work; Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Boehringer Ingelheim, and American College of Chest Physicians, outside the submitted work; participation on Fibrogen Adjudication Committee, outside the submitted work; and is part of the Chair Scientific Review Committee of the Pulmonary Fibrosis Foundation, outside the submitted work.
Conflict of interest: Dr. Khor reports grants from NHMRC Investigator Grant, during the conduct of the study; non-financial support from Air Liquide Healthcare, outside the submitted work.
Conflict of interest: Dr. Inoue reports grants from Japanese Ministry of Health, Labour, and Welfare, grants from Japan Agency for Medical Desearch and Development, advisory board participation and lecture fees from Boehringer Ingelheim, Inc, lecture fees from Shionogi & Co Ild, Kyorin Pharmaceutical Co Ltd, GSK and Novartis, advisory board participation for Roche/Promedior, Galapagos, Taiho pharma, CSL Behring, Vicore Pharma, outside the submitted work.
Conflict of interest: Dr. Oldham reports grants from National Institutes of Health, grants from Boehringer Ingelheim, during the conduct of the study; personal fees from Boehringer Ingelheim, personal fees from Roche/Genentech, data monitoring committee participation for Novartis, Endeavor BioMedicines, and Genenetch, personal fees from Lupin Pharmaceuticals, personal fees from Gatehouse Bio, outside the submitted work.
Conflict of interest: Dr. McDonald reports personal fees from GlaxoSmithKline, personal fees from AstraZeneca, personal fees from Arterial Group, grants from Ramaciotti Foundation Grant, grants from MRFF, grants from JHH Charitable Trust, grants from NHMRC, outside the submitted work.
Conflict of interest: Dr. Russell reports lecture fees from Boehringer Ingelheim, Hoffman La Roche , Irish Lung Fibrosis Association, Respiratory Professional Care, and the Interstitial Lung Disease Interdisciplinary Network, educational resource development forBoehringer Ingelheim, and consultancy for Hoffman La Roche , Irish Lung Fibrosis Association, Respiratory Professional Care, and the Interstitial Lung Disease Interdisciplinary Network, outside the submitted work.
Conflict of interest: Dr. Ryerson reports grants and personal fees from Boehringer Ingelheim, grants and personal fees from Hoffmann-La Roche , personal fees from Veracyte, personal fees from Pliant Therapeutics, personal fees from Astra Zeneca, personal fees from Cipla Ltd, grants from VIDA diagnostics, personal fees from Trevi Therapeutics, outside the submitted work.
Conflict of interest: Anne Holland has nothing to disclose.
- Received March 8, 2023.
- Accepted May 16, 2023.
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