Advancing in precision asthma management: The Treat-to-Target by Treatable Traits (T4) framework

In the era of biologic therapy, the management of severe asthma is evolving towards personalized medicine frameworks that integrate clinical, functional, and biological traits. In this narrative review, we explore the convergence of Treatable Traits and Treat-to-Target principles within a unified concept known as Treat-to-Target by Treatable Traits (T4) Framework. The T4 Framework introduces an innovative methodology for the management of severe asthma through a trait-oriented and target-focused paradigm. We propose a conceptual approach that emphasizes remission as a realistic and clinically meaningful target, but that must be sought through a tailored approach to the multiple heterogeneous features of the disease. This T4 Framework aims to streamline treatment strategies, enhancing patient outcomes by addressing the specific characteristics of severe asthma and facilitating a more effective management pathway. Implementing the T4 Framework may significantly improve the personalization of asthma management, ultimately leading to better control and quality of life for patients with severe asthma.