Treatable trait Treatment What treatment success looks like
Airway
Eosinophilic airway inflammation Reversible airflow obstruction due to smooth muscle constriction Airway bacterial infection ICS Salbutamol Ipratropium ?Tiotropium Antibiotics Fewer and less severe wheeze attacks Improved quality of life Less severe wheeze attacks Improved quality of life Eradication of infection Fewer and less severe wheeze attacks Improved quality of life
Extra-pulmonary
Obesity Gastro-oesophageal reflux Unsafe swallow Rhinitis Eczema Food allergy Weight reduction May be coincidental PPI Thicken feeds Antihistamine Nasal steroids Emollients Topical steroids Avoidance Restore normal BMI Fewer wheeze attacks and better quality of life Fewer wheeze attacks and better quality of life Improved symptoms Rash and itching resolved No allergic reactions
Social/ Environmental Nicotine exposure (tobacco or vapes) Exposure to allergens to which child sensitised Refer to smoking cessation clinic Allergen avoidance, including pet removal Exposure ceases, fewer attacks and better quality of life Exposure ceases, fewer attacks and better quality of life