Identifying and assessing the prognostic implications of treatable traits in asthma and COPD

Bakgrund:

The mortality rate for asthma has flattened out, and only a minority of patients have well-controlled asthma. COPD shortens life expectancy by eight years. As there is a need to make progress in both asthma and COPD, the concept of treatable traits has been introduced. Treatable traits can be pulmonary; extrapulmonary, environmental and behavioural. The idea behind the treatable trait concept is that each patient should have a personalised treatment based on the patients' identified traits.

Målsättning:

1. To study the prevalence of and correlation between treatable traits such as eosinophilic inflammation, bronchodilatory reversibility, allergic sensitisation, and comorbidities. 2. To study stability and change of treatable traits over time.

3. To study the longitudinal association between treatable traits and exacerbations, hospitalisation and mortality and to study the interaction between these associations and treatment. 4. To study associations between treatable traits and the use of inhaled corticosteroids and pneumonia in asthma. Arbetsplan:

We will identify treatable traits using data from the SCAPIS study in Uppsala. The Uppsala part is the only one that includes information on allergic sensitisation and type-2 inflammatory markers. We will study how treatable traits vary over time using data from two Nordic longitudinal studies: RHINE and BOLD.

Two studies were the data is merged with national register data will be used to study the association between treatable traits and exacerbations, hospitalisation and mortality. We will also investigate the interaction between these associations the pharmacological treatment.

We will study associations between treatable traits, the use of inhaled corticosteroids, and pneumonia in asthma using a large primary care database from the UK. Betydelse:

The concept of treatable traits is one of the most promising ideas that has arisen in recent years. This concept has the potential of radically improving prognosis asthma and COPD. To study this concept in detail, large population samples are needed.

In this proposal, we have the possibility to investigate the clinical implication of treatable traits in population studies, and cohort studies that taken together include more than 400 000 participants. Another unique feature from an international perspective is the possibility to utilise the national register data to study the interaction between treatable traits and pharmacological treatment.