Choosing wisely: practical considerations on treatment efficacy and safety of asthma in the elderly
Year: 2015
Type: article
Abstract: The prevalence of asthma in the most advanced ages is similar to that of younger ages. However, the concept that older individuals may suffer from allergic asthma has been largely denied in the past, and a common belief attributes to asthma the definition of "rare" disease. Indeed, asthma in the elderly is often underdiagnosed or diagnosed as COPD, thus leading to undertreatment of improper treatment. This is also due to the heterogeneity of clinical and functional presentations of geriatric asthma, including the partial loss of reversibility and the lower occurrence of the allergic component in this age range. The older asthmatic patients are also characterized the coexistence of comorbid conditions that, in conjunction with age-associated structural and functional changes of the lung, may contribute to complicate the management of asthma. The current review addresses the main issues related to the management of allergic asthma in the geriatric age. In particular, the paper aims at revising current pharmacological and non pharmacological treatments for allergic asthmatics of advanced ages, primarily focusing on their safety and efficacy, although most behaviors are an arbitrary extrapolation of what has been tested in young ages. In fact, age has always represented an exclusion criterion for eligibility to clinical trials. Experimental studies and real life observations specifically testing the efficacy and safety of therapeutic approaches in allergic asthma in the elderly are urgently needed.
Source: Clinical and Molecular Allergy
Authors: Nicola Scichilone, Maria T Ventura, Matteo Bonini, Fulvio Braido, Caterina Bucca, Marco Caminati, Stefano Del Giacco, Enrico Heffler, Carlo Lombardi, Andrea Matucci, Manlio Milanese, Roberto Paganelli, Giovanni Passalacqua, Vincenzo Patella, Erminia Ridolo, Giovanni Rolla, Oliviero Rossi, Domenico Schiavino, Gianenrico Senna, Gundi Steinhilber, Alessandra Vultaggio, Giorgio Canonica
Institutions: University of Palermo, University of Bari Aldo Moro, Sapienza University of Rome, Ospedale Policlinico San Martino, University of Genoa, University of Turin, University of Verona, University of Cagliari, University of Catania, Fondazione Poliambulanza Istituto Ospedaliero, Azienda Ospedaliero-Universitaria Careggi, Azienda Sanitaria Locale N. 2 Savonese, University of Chieti-Pescara, Azienda Sanitaria Locale Salerno, University of Parma, A. O. Ordine Mauriziano di Torino, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,490
OpenAlex ID: W1975463863