The 5T Approach in Asthma: Triple Therapy Targeting Treatable Traits

REVIEW ARTICLE| VOLUME 200, 106915, 

https://doi.org/10.1016/j.rmed.2022.106915 

A systematic approach to addressing treatable traits in asthma is clinically effective. Eosinophilic airway inflammation, airflow limitation, and tendency to exacerbations are treatable traits present in many of the clinical phenotypes of asthma, further pulmonary treatable traits such as mucus hypersecretion, oxygen desaturation, dyspnea, neutrophilic airway inflammation and small airway involvement, extrapulmonary traits, behavioral traits, and risk factors also deserve attention.

The results of several RCTs document the importance of using the single inhaler triple therapy with ICS, LABA, and LAMA in poorly controlled asthma despite the use of ICS/LABA. 

Why This Is Important: Most asthma experts have always felt that many asthmatics have some elements of obstructive lung disease. I suspect this is especially true for Black Americans and underserved communities where asthma control is less common and often unpredictable. New therapies that combine therapies effective for both asthma and COPD in a single inhaler deserve much more consideration when medical therapy for asthma is being considered.

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