Personalised medicine in asthma: from curative to preventive medicine

摘要

The concept of asthma has changed substantially in recent years. Asthma is now recognised as a heterogeneous entity that is complex to treat. The subdivision of asthma; provided by xe2x80x9cclusterxe2x80x9d analyses; has revealed various groups of asthma patients who share phenotypic features. These phenotypes underlie the need for personalised asthma therapy because; in contrast to the previous approach; treatment must be tailored to the individual patient. Determination of the patient's asthma phenotype is therefore essential but sometimes challenging; particularly in elderly patients with a multitude of comorbidities and a complex exposure history. This review first describes the various asthma phenotypes; some of which were defined empirically and others through cluster analysis; and then discusses personalisation of the patient's diagnosis and therapy; addressing in particular biological therapies and patient education. This personalised approach to curative medicine should make way in the coming years for personalised preventive and predictive medicine; focused on subjects at risk who are not yet ill; with the aim of preventing asthma before it occurs. The concept of personalised preventive medicine may seem a long way off; but is it really?