According to Frances Gardiner, Global Medical Affairs Lead in Asthma, a more personalised approach to asthma treatment may help us improve the lives of millions.
Asthma affects 339 million people worldwide. That’s 339 million people who may struggle to sleep, struggle to exercise, struggle to work, struggle to study, struggle to live an unimpeded life, and struggle to breathe.[1][2]
A more personalised approach to the management of respiratory diseases may help us improve the lives of millions. We know that not all asthma is the same and that different factors contribute to poor control of the condition.
The reason people with asthma find these activities challenging is down to the symptoms they can experience on a regular basis, including shortness of breath, chest tightness and wheezing. Targeting certain treatable traits an individual may exhibit could have a significant impact on their quality of life.
At GSK, we are partnering with respiratory experts to investigate a more personalised approach, with the aim to improve how we can manage respiratory conditions in the future and ensure the right patients receive the right treatment. Traits differ from person to person, and we believe that by studying the evidence behind this, we’ll be able to treat different aspects of asthma and other respiratory conditions more effectively.
Why treatable traits are worth targeting
Treatable traits take many forms. They may include aggravating factors, comorbidities, or features of the disease itself – such as patients with severe eosinophilic asthma who have raised eosinophil levels. Eosinophils are a type of white blood cell which form part of our immune system and, at normal levels, help protect our bodies against infection. However, over-production can inflame vital organs and tissues, including the lungs. Once airways narrow, it becomes difficult to breathe.
Smoking, physical inactivity, low or high BMIs, anxiety and depression are also examples of treatable traits. By better understanding the reasons behind how and why asthma affects each patient in different ways, we can identify and address such traits individually to help people manage their symptoms better, and potentially improve outcomes too.
Beyond asthma, data shows that identifying and managing specific treatable traits could help patients manage exacerbations and flare-ups in conditions such as cystic fibrosis, and more recently in chronic obstructive pulmonary disease (COPD). Up to 40% of COPD patients have abnormal eosinophilic inflammation, which is associated with an increased risk of exacerbations.
One size does not fit all
The traditional stepwise approach follows a route by which each patient receives a similar treatment follow the initial diagnosis. The treatable traits approach looks at the individual and asthma characteristics or ‘traits’ they exhibit. The traits guide the choice of medicine to address the factors involved in the poor control of their condition.
The value of a personalised approach
At GSK we are continuously investing in research with the potential to progress patient care in asthma. This includes furthering our understanding of how best to use available treatments.
Not all asthma is the same. Every patient’s experience of asthma is unique, and different treatments may help them in different ways depending on how their asthma impacts them. Helping those patients who continue to experience symptoms, despite being on the current standard of care, is central to our aims and ongoing work in this field.
Our research has shown that it’s possible to segment asthma patients to provide more personalised treatment plans. Together with our partners, we will continue our research to help us target more treatable traits, so we can improve the lives of the millions living with asthma around the world.
References
[1] Woodcock A, et al. Lancet 2017;290:2247-2255.
[2] Soriano JB et al. Lancet Resp Med. 2017.5(9) :691-706.
[3] World Health Organization. Asthma Factsheet. Published May 2020. Available online at: https://www.who.int/news-room/fact-sheets/detail/asthma. Last accessed April 2021.
[4] Akuthota P and Weller PF. Immunol Allergy Clin North Am. 2015 August ; 35(3): 403–411.
[5] Kerkhof M, et al.Thorax. 2018;73:116–124.
[6] Walford HH & Doherty TA. Journal of Asthma and Allergy. 2014; 7:53-65.
[7] Bateman ED, et al. Am J Respir Crit Care Med. 2004;170:836–44.
[8] McDonald VM, Fingleton J, Agusti A, et al. Eur Respir J. 2019;53(5):1802058.
