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Published on: June 16, 2020
Treatable traits approach for personalised management of sarcoidosis
Francesco Amati1,2, Anna Stainer3,2, Letizia Corinna Morlacchi4,5
1Respiratory Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy francesco.amati@hunimed.eu.
Abstract:
In sarcoidosis, personalised strategies that consider the various phenotypes and endotypes of the disease have the potential to improve patient care. The 'treatable traits' (TT) approach offers a promising strategy that has already been proposed and implemented in several other chronic pulmonary diseases. In this review, we propose five distinct TT categories for patients with sarcoidosis: aetiological, lifestyle, pulmonary, extrapulmonary (systemic) and comorbidities.Despite the potential of this strategy, several challenges hinder its implementation. In addition, much of the knowledge on the definition and prevalence of TTs comes from single-centre studies. Creating international registries will enhance our understanding and provide more accurate data on these traits.TTs are dynamic and require continuous evaluation to effectively respond to changes caused by disease progression or treatment response. A multidisciplinary management approach is therefore crucial as sarcoidosis can impact multiple organs. Integrating primary care physicians into the management framework will improve overall patient care.Incorporating patient preferences into the TT strategy is vital for improving adherence to treatment. Additionally, using patient-reported outcome measures will provide valuable insights into the impact of treatment.While the TT approach is feasible in developed healthcare systems, challenges exist in resource-limited settings. Advancing patient-centred care towards 5P medicine involves addressing key TTs that meet the unique patient needs.Therefore, randomised controlled trials focused on TTs are needed. Our proposed TT strategy aims to enhance quality of life and outcomes for patients with sarcoidosis while increasing awareness of the importance of TTs among healthcare providers and advocacy groups.
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