Choosing wisely: Practical considerations on treatment efficacy and safety of asthma in the elderly

Nicola Scichilone, Enrico Heffler, Gianenrico Senna, Marco Caminati, Giorgio Canonica, Matteo Bonini, Stefano Del Giacco, Gundi Steinhilber, Manlio Milanese, Caterina Bucca, Alessandra Vultaggio, Nicola Scichilone, Erminia Ridolo, Andrea Matucci, Vincenzo Patella, Oliviero Rossi, Domenico Schiavino, Roberto Paganelli, Giovanni Passalacqua, Carlo LombardiGiovanni Rolla, Maria T. Ventura, Fulvio Braido

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)

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.
Original languageEnglish
Pages (from-to)1-14
Number of pages14
JournalClinical and Molecular Allergy
Volume13
Publication statusPublished - 2015

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology
  • Molecular Biology

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