Are biological drugs effective and safe in older severe asthmatics?

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Abstract

Introduction: The treatment of asthma in older ages follows the recommendations of international guidelines for the management of asthma in younger ages, although older age has always represented an exclusion criterion for eligibility to pharmacological trials. This poses a clinical challenge when deciding whether elderly severe asthmatics are candidates for biological drugs. Areas covered: The current article has a narrative structure to review the current literature on efficacy and safety of novel pharmacological drugs against immunoglobulins and interleukins that mediate and orchestrate the main inflammatory pathways in severe asthma, in order to explore whether older subjects (i.e. > 65 years of age) are included. Expert opinion: Asthma in older ages is not a rare entity, and loss of symptom control is common in most advanced ages. Current evidence from randomized clinical trials (RCTs) on the safety of biological drugs in elderly asthmatics is scarce and does not allow drawing definitive conclusions. An urgent call for studies specifically designed for elderly populations is needed, with the purpose to assess the efficacy and safety of target biological therapies in advanced ages. We envision the design of large multi-center clinical trials to decide whether and when geriatric population could benefit from biological therapies.
Lingua originaleEnglish
pagine (da-a)369-380
Numero di pagine12
RivistaExpert Opinion on Drug Safety
Volume18
Stato di pubblicazionePublished - 2019

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Asthma
Biological Therapy
Safety
Pharmaceutical Preparations
Pharmacology
Interleukins
Expert Testimony
Geriatrics
Population
Immunoglobulins
Randomized Controlled Trials
Clinical Trials
Guidelines
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

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title = "Are biological drugs effective and safe in older severe asthmatics?",
abstract = "Introduction: The treatment of asthma in older ages follows the recommendations of international guidelines for the management of asthma in younger ages, although older age has always represented an exclusion criterion for eligibility to pharmacological trials. This poses a clinical challenge when deciding whether elderly severe asthmatics are candidates for biological drugs. Areas covered: The current article has a narrative structure to review the current literature on efficacy and safety of novel pharmacological drugs against immunoglobulins and interleukins that mediate and orchestrate the main inflammatory pathways in severe asthma, in order to explore whether older subjects (i.e. > 65 years of age) are included. Expert opinion: Asthma in older ages is not a rare entity, and loss of symptom control is common in most advanced ages. Current evidence from randomized clinical trials (RCTs) on the safety of biological drugs in elderly asthmatics is scarce and does not allow drawing definitive conclusions. An urgent call for studies specifically designed for elderly populations is needed, with the purpose to assess the efficacy and safety of target biological therapies in advanced ages. We envision the design of large multi-center clinical trials to decide whether and when geriatric population could benefit from biological therapies.",
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author = "Salvatore Battaglia and Nicola Scichilone and Alida Benfante and Stefania Principe",
year = "2019",
language = "English",
volume = "18",
pages = "369--380",
journal = "Expert Opinion on Drug Safety",
issn = "1474-0338",
publisher = "Informa Healthcare",

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TY - JOUR

T1 - Are biological drugs effective and safe in older severe asthmatics?

AU - Battaglia, Salvatore

AU - Scichilone, Nicola

AU - Benfante, Alida

AU - Principe, Stefania

PY - 2019

Y1 - 2019

N2 - Introduction: The treatment of asthma in older ages follows the recommendations of international guidelines for the management of asthma in younger ages, although older age has always represented an exclusion criterion for eligibility to pharmacological trials. This poses a clinical challenge when deciding whether elderly severe asthmatics are candidates for biological drugs. Areas covered: The current article has a narrative structure to review the current literature on efficacy and safety of novel pharmacological drugs against immunoglobulins and interleukins that mediate and orchestrate the main inflammatory pathways in severe asthma, in order to explore whether older subjects (i.e. > 65 years of age) are included. Expert opinion: Asthma in older ages is not a rare entity, and loss of symptom control is common in most advanced ages. Current evidence from randomized clinical trials (RCTs) on the safety of biological drugs in elderly asthmatics is scarce and does not allow drawing definitive conclusions. An urgent call for studies specifically designed for elderly populations is needed, with the purpose to assess the efficacy and safety of target biological therapies in advanced ages. We envision the design of large multi-center clinical trials to decide whether and when geriatric population could benefit from biological therapies.

AB - Introduction: The treatment of asthma in older ages follows the recommendations of international guidelines for the management of asthma in younger ages, although older age has always represented an exclusion criterion for eligibility to pharmacological trials. This poses a clinical challenge when deciding whether elderly severe asthmatics are candidates for biological drugs. Areas covered: The current article has a narrative structure to review the current literature on efficacy and safety of novel pharmacological drugs against immunoglobulins and interleukins that mediate and orchestrate the main inflammatory pathways in severe asthma, in order to explore whether older subjects (i.e. > 65 years of age) are included. Expert opinion: Asthma in older ages is not a rare entity, and loss of symptom control is common in most advanced ages. Current evidence from randomized clinical trials (RCTs) on the safety of biological drugs in elderly asthmatics is scarce and does not allow drawing definitive conclusions. An urgent call for studies specifically designed for elderly populations is needed, with the purpose to assess the efficacy and safety of target biological therapies in advanced ages. We envision the design of large multi-center clinical trials to decide whether and when geriatric population could benefit from biological therapies.

KW - Age Factors

KW - Aged

KW - Anti-Asthmatic Agents

KW - Asthma

KW - Asthma/drug therapy

KW - Biological Products

KW - Humans

KW - Immunoglobulins

KW - Interleukins

KW - Practice Guidelines as Topic

KW - Randomized Controlled Trials as Topic

KW - Severity of Illness Index

KW - anti-asthmatic agents/pharmacology

KW - antibodies

KW - humanized

KW - monoclonal

KW - pulmonary eosinophilia/drug therapy

UR - http://hdl.handle.net/10447/360031

UR - https://www.tandfonline.com/loi/ieds20

M3 - Article

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SP - 369

EP - 380

JO - Expert Opinion on Drug Safety

JF - Expert Opinion on Drug Safety

SN - 1474-0338

ER -