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Identification of pulmonary treatable traits in a real-life setting

Identification of treatable traits is proposed as a precision medicine approach for asthma and COPD. We sought to characterise the pulmonary treatable traits in patients attending the Oxford Centre for Respiratory Medicine (2014-2017). Adults with a physician diagnosis of asthma or COPD were recruited (n=214). Clinical demographics, medication use and medical history was recorded. Whole blood, induced sputum, and spirometry with reversibility and disease specific symptoms were assessed. Qualitative CT reports were recorded within 2 years of the study visit. The cohort were older adults (mean age 55 years, 53% female) who were prescribed a high dose of inhaled corticosteroids (1000 micrograms). Pulmonary traits identified and their frequency is shown below.
 The most commonly assessed trait was chronic bronchitis. The commonest treatable trait identified was eosinophilic inflammation (defined as a sputum eosinophil proportion >3% and/or a blood eosinophil number >300 and/or FeNO >50ppb). Airflow limitation was more common in COPD (87% vs. 45%, p Pulmonary treatable traits are common in a secondary care setting. Eosinophilic airway inflammation was frequently assessed and persistent despite high doses of inhaled cortiocoteroids.