Abstract
Several current guidelines/strategies outline a treatment approach to asthma, which primarily consider the goals of improving lung function and quality of life and reducing symptoms and exacerbations. They suggest a strategy of stepping-up or down treatment, depending on the patient's overall current asthma symptom control and future risk of exacerbation. While this stepwise approach is undeniably practical for daily practice, it does not always address the underlying mechanisms of this heterogeneous disease. In the last decade, there has been an attempt to improve the treatment of severe asthma such as the addition of long-acting antimuscarinic agent to the traditional ICS/LABA treatment, and the introduction of therapies targeting key cytokines. However, despite such strategies several unmet needs in this population remain, motivating research to identify novel targets and develop improved therapeutic and/ or preventative asthma treatments. Pending the availability of such therapies, it is essential to re-evaluate the current conventional 'one-size-fits-all' approach to a more precise asthma management. Although challenging, identifying 'treatable traits” that contribute to respiratory symptoms in individual patients with asthma may allow a more pragmatic approach to establish more personalized therapeutic goals.
Footnotes
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Conflict of interest: Mario Cazzola participated as a faculty member and advisor in scientific meetings and courses under the sponsorship of Abdi Ibrahim, Alkem, Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Cipla, GlaxoSmithKline, Glenmark, Lallemand, Mankind Pharma, Menarini Group, Mundipharma, Novartis, Pfizer, Recipharm, Sanofi, Teva, Verona Pharma, and Zambon and is or was a consultant to ABC Farmaceutici, AstraZeneca, Chiesi Farmaceutici, GlaxoSmithKline, Lallemand, Novartis, Ockham Biotech, Recipharm, Verona Pharma, and Zambon.
Conflict of interest: Clive p Page has acted as a consultant to Eurodrug, Recipharm, Glycosynnovation and PrEP Biopharma. CPP also holds equity in Verona Pharma.
Conflict of interest: Maria Gabriella Matera participated as a faculty member and advisor in scientific meetings and courses under the sponsorship of ABC Farmaceutici, Almirall, AstraZeneca, Chiesi Farmaceutici, GlaxoSmithKline, and Novartis and was a consultant to Chiesi Farmaceutici and GlaxoSmithKline. Her department was funded by GlaxoSmithKline and Novartis.
Conflict of interest: Paola Rogliani has participated as a faculty member and advisor in scientific meetings and courses under the sponsorship of Almirall, AstraZeneca, Biofutura, Boehringer Ingelheim, Chiesi Farmaceutici, GlaxoSmithKline, Menarini Group, Mundipharma, Novartis, Recipharm, Sanofi, and Zambon, and her department was funded by Almirall, Boehringer Ingelheim, Chiesi Farmaceutici, Novartis, and Zambon.
Conflict of interest: Nicola A. Hanania received honoraria for serving as advisor or consultant for GlaxoSmithKline, AstraZeneca, Sanofi, Regeneron, Amgen, Genentech, Novartis and Teva. His institution received research grant support on his behalf from GlaxoSmithKline, Genentech, Sanofi, Teva, Novartis, and Astra Zeneca
Conflict of interest: The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in, or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
- Received April 25, 2023.
- Accepted June 25, 2023.
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