Can Treatable Traits Be the Approach to Addressing the Complexity and Heterogeneity of COPD?
Articolo
Data di Pubblicazione:
2023
Citazione:
Can Treatable Traits Be the Approach to Addressing the Complexity and Heterogeneity of COPD? / M. Cazzola, P. Rogliani, F. Blasi. - In: INTERNATIONAL JOURNAL OF COPD. - ISSN 1178-2005. - 2023:18(2023), pp. 1959-1964. [10.2147/COPD.S428391]
Abstract:
The complexity of COPD implies the need to identify groups of patients with similar clinical characteristics and prognosis
or treatment requirements. This is why much attention has been paid to identifying the different clinical phenotypes by investigating
the clinical expression of the disease, and endotypes by studying the biological networks that enable and limit reactions. However, this
approach is complicated because one endotype gives rise to one or more clinical characteristics, and clinical phenotypes can be derived
from several endotypes. To simplify the approach, a new taxonomic classification of COPD based on the different causes (or etiotypes)
has been proposed, but these etiotypes have not yet been validated. A simpler method is the so-called tractable traits approach, which
is free from any designation of the disorder to be treated and does not present the criticality of using etiotypes. A large randomised
controlled trial on using the treatable traits approach in COPD is still lacking. Nevertheless, this approach is already applied by
following the GOLD strategy. However, its application is complicated because several potentially treatable traits have been identified
within the pulmonary domain, the extrapulmonary domain, and the behavioural/risk factor domain. In addition, the hierarchy of the
dominant treatable traits has not yet been established, and they change over time both spontaneously and because of treatment. This
means that the patients being treated according to the tractable traits approach must be constantly followed over time so that the
therapy is focused on their temporal needs.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
chronic obstructive pulmonary disease; phenotypes; endotypes; etiotypes; treatable traits
Elenco autori:
M. Cazzola, P. Rogliani, F. Blasi
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