Abstract
Background “Treatable traits (TTs)” is a precision medicine approach for facilitating multidimensional assessment of every patient with chronic airway disease to determine the core traits associated with disease outcomes, where targeted treatments are applied.
Objectives To determine the prevalence of TTs in chronic obstructive pulmonary disease (COPD) and which traits predict future decline in lung function and quality of life (QoL).
Methods A 4 year longitudinal evaluation was conducted using data from 3726 participants in the English Longitudinal Study of Ageing (ELSA). TTs were identified based on published recommendations. Traits that predicted decline in lung function and QoL were analysed using generalised estimating equations.
Results Overall, 21 TTs, including pulmonary (n=5), extra-pulmonary (n=13) and behavioural/lifestyle risk-factors (n=3) were identified. In multivariate analyses, traits of chronic bronchitis (β=−0.186; 95%CI=−0.290 to −0.082), breathlessness (β=−0.093; 95%CI=−0.164 to −0.022), underweight (β=−0.216; 95%CI=−0.373 to −0.058), sarcopaenia (β=−0.162; 95%CI=−0.262 to −0.061), and current smoking (β=−0.228; 95%CI=−0.304 to −0.153), predicted decline in forced expiratory volume in 1 s (FEV1). Of the seven traits that predicted decline in QoL, depression (β=−7.19; 95%CI=−8.81 to −5.57) and poor family and social support (β=−5.12; 95%CI=−6.65 to −3.59) were the strongest.
Conclusion The core TTs of COPD associated with a decline in lung function and QoL were identified. Targeting these impactful traits and individualised treatment using a precision medicine approach may improve outcomes in people with COPD.
Footnotes
This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.
Conflict of interests: Dr. Sarwar has nothing to disclose.
Conflict of interests: Dr. McDonald reports grants, personal fees and non-financial support from GSK, grants, personal fees and non-financial support from AstraZeneca, grants from NHMRC, grants from Cyclopharm, grants from Ramaciotti, non-financial support from Menarini, outside the submitted work.
Conflict of interests: Dr. Abramson reports grants and personal fees from GSK, grants from Pfizer, grants from Boehringer-Ingelheim, non-financial support from Sanofi, outside the submitted work.
Conflict of interests: Dr. Paul has nothing to disclose.
Conflict of interests: Dr. George reports grants from GSK, grants from Pfizer, grants from Boehringer-Ingelheim, outside the submitted work.
This is a PDF-only article. Please click on the PDF link above to read it.
- Received December 14, 2020.
- Accepted January 28, 2021.
- ©The authors 2021
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org
