The Impact of Treatable Traits on Clinical Remission in Patients With Asthma.

Abstract

The impact of treatable traits on clinical remission in asthma remains unclear, despite their recognition as potential therapeutic targets for personalized care. This study investigated the association between treatable traits and clinical remission in asthma and identified specific traits influencing remission rates. A multicenter, cross-sectional questionnaire survey was conducted at 26 centers in Japan between September and November 2021. Clinical remission was defined as an Asthma Control Test score of 20 or greater, FEV₁ of at least 80%, no exacerbations, and no oral corticosteroid use over the past year. Assessed treatable traits included a peripheral blood eosinophil count of 300/μL or greater, FeNO 25 parts per billion or greater, systemic allergic inflammation, obesity, depression, dysfunctional breathing, and current smoking. Among 2,154 participants, 1,350 were included in the final analysis, whereas we excluded 679 patients with missing data and 125 using biologics. Median treatable traits per patient was two. Clinical remission rates decreased significantly as the number of treatable traits increased(P < .05,Cochran-Armitage test). Logistic regression identified the number of treatable traits as an independent risk factor for remission (odds ratio = 0.685; P < .001). Peripheral blood eosinophil count, elevated FeNO, and depression were also independent risk factors (odds ratio = 0.622; 95% CI, 0.617-0.340; P < .05). In patients with non-biologic treated bronchial asthma, a higher number of treatable traits was associated with lower clinical remission rates. Targeted treatment for type 2 inflammation and supportive care for depression may improve remission outcomes.