TY - JOUR T1 - Targeting treatable traits in severe asthma: a randomised controlled trial JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01509-2019 VL - 55 IS - 3 SP - 1901509 AU - Vanessa M. McDonald AU - Vanessa L. Clark AU - Laura Cordova-Rivera AU - Peter A.B. Wark AU - Katherine J. Baines AU - Peter G. Gibson Y1 - 2020/03/01 UR - http://erj.ersjournals.com/content/55/3/1901509.abstract N2 - Rationale Treatable traits have been proposed as a new paradigm for airway disease management.Objectives To characterise treatable traits in a severe asthma population and to determine the efficacy of targeting treatments to these treatable traits in severe asthma.Methods Participants (n=140) with severe asthma were recruited to a cross-sectional study and underwent a multidimensional assessment to characterise treatable traits. Eligible participants with severe asthma (n=55) participated in a 16-week parallel-group randomised controlled trial to determine the feasibility and efficacy of management targeted to predefined treatable traits, compared to usual care in a severe asthma clinic. The patient-reported outcome of health-related quality of life was the trial's primary end-point.Main results Participants with severe asthma had a mean±sd of 10.44±3.03 traits per person, comprising 3.01±1.54 pulmonary and 4.85±1.86 extrapulmonary traits and 2.58±1.31 behavioural/risk factors. Individualised treatment that targeted the traits was feasible and led to significantly improved health-related quality of life (0.86 units, p<0.001) and asthma control (0.73, p=0.01).Conclusions Multidimensional assessment enables detection of treatable traits and identifies a significant trait burden in severe asthma. Targeting these treatable traits using a personalised-medicine approach in severe asthma leads to improvements in health-related quality of life, asthma control and reduced primary care acute visits. Treatable traits may be an effective way to address the complexity of severe asthma.Treatable traits is a new paradigm for the management of airway disease. Managing patients with severe asthma using this approach improves health-related quality of life, and validates this as a useful management paradigm for severe asthma. http://bit.ly/2R9xRJh ER -