PT  - JOURNAL ARTICLE
AU  - Sarwar, Muhammad Rehan
AU  - McDonald, Vanessa Marie
AU  - Abramson, Michael John
AU  - Paul, Eldho
AU  - George, Johnson
TI  - Treatable traits in an English cohort: prevalence and predictors of future decline in lung function and quality of life in COPD
AID  - 10.1183/23120541.00934-2020
DP  - 2021 Apr 01
TA  - ERJ Open Research
PG  - 00934-2020
VI  - 7
IP  - 2
4099  - http://openres.ersjournals.com/content/7/2/00934-2020.short
4100  - http://openres.ersjournals.com/content/7/2/00934-2020.full
SO  - erjor2021 Apr 01; 7
AB  - Background “Treatable traits (TTs)” is a precision medicine approach for facilitating multidimensional assessment of every patient with chronic airway disease, in order to determine the core traits associated with disease outcomes where targeted treatments may be 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, the 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), sarcopenia (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 with individualised treatment using a precision medicine approach may improve outcomes in people with COPD.Targeting the traits of chronic bronchitis, breathlessness, underweight, sarcopenia, depression, smoking, and poor family and social support may significantly improve health outcomes in people with COPD https://bit.ly/3cLHIPV