Patients who walked more than 7500 steps daily were less likely to have uncontrolled asthma.

Recognising the heterogeneity of asthma and the need for precision medicine, ‘treatable traits’ is a framework that helps clinicians identify and target individual disease traits rather than employ a one-treatment-fits-all process. Examples of treatable traits include physical inactivity, sedentarism (defined as being inactive for more than eight hours daily), smoking, obesity, reflux, anxiety and depression, airflow obstruction, mucous production and eosinophilia.

In a cross-sectional Brazilian study, 426 adults with moderate-to-severe asthma were assessed for asthma control and anxiety and depression using questionnaires. Physical activity was determined by actigraphy for seven consecutive days. Patients who were physically active (defined as walking 7500 or more steps daily) were significantly more likely to have partial or good asthma control than patients who were inactive (44% vs 24%); physically active patients also had less anxiety and depression. Sedentarism and obesity were not related to asthma control.

Comment: Addressing treatable traits such as physical inactivity, anxiety and depression, and smoking are as important as picking the ‘right’ inhaler or biologic. Because this is a cross-sectional, observational study, we do not know for sure whether inactivity contributed to worse asthma control or whether difficult-to-control asthma was a major reason for inactivity; nevertheless, the findings give us a reason to promote physical activity in most patients with asthma. I frequently hear patients say, ‘I can’t exercise because I have asthma.’ I answer, ‘Let’s work together to see how we can get you more active.’

David J. Amrol, MD, Associate Professor of Clinical Internal Medicine, Director of the Division of Allergy and Immunology, University of South Carolina School of Medicine, Columbia, USA.

de Lima FF, et al. Physical activity and sedentary behavior as treatable traits for clinical control in moderate-to-severe asthma. J Allergy Clin Immunol Pract 2024; 12: 2047-2055.

This summary is taken from the following Journal Watch titles: General Medicine, Ambulatory Medicine.