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

被引：25

作者：

Scichilone N. ^{[1
]}

Ventura M.T. ^{[2
]}

Bonini M. ^{[3
]}

Braido F. ^{[4
]}

Bucca C. ^{[5
]}

Caminati M. ^{[6
]}

Del Giacco S. ^{[7
]}

Heffler E. ^{[8
]}

Lombardi C. ^{[9
]}

Matucci A. ^{[10
,16
]}

Milanese M. ^{[11
]}

Paganelli R. ^{[12
]}

Passalacqua G. ^{[4
]}

Patella V. ^{[13
]}

Ridolo E. ^{[14
]}

Rolla G. ^{[15
]}

Rossi O. ^{[16
]}

Schiavino D. ^{[17
]}

Senna G. ^{[6
]}

Steinhilber G. ^{[18
]}

Vultaggio A. ^{[10
,16
]}

Canonica G. ^{[4
]}

机构：

[1] Department of Medicine, University of Palermo, via Trabucco 180, Palermo

[2] Interdisciplinary Department of Medicine, Unit of Geriatric Immunoallergology, University of Bari, Bari

[3] Lung Function Unit, Department of Public Health and Infectious Diseases Sapienza, University of Rome, Rome

[4] Respiratory Diseases and Allergy Clinic, University of Genoa, IRCCS AOU San Martino-IST, Genoa

[5] Pneumology Unit, Department of Medical Sciences, University of Turin, AOU San Giovanni Battista, Torino

[6] Allergy Unit, Verona University and General Hospital, Verona

[7] Department of Medical Sciences M. Aresu, University of Cagliari, Cagliari

[8] Department of Clinical and Experimental Medicine - Respiratory Medicine and Allergy, University of Catania, Catania

[9] Departmental Unit of Allergology-Clinical Immunology and Pneumology, Fondazione Poliambulanza, Brescia

[10] Centre of Excellence DENOTHE, Dept. of Experimental and Clinical Medicine, Units of Immunoallergology Azienda Ospedaliero-Universitaria Careggi, Florence

[11] Struttura Complessa di Pneumologia, ASL2 Savonese, Savona

[12] Laboratory of Immunology and Allergy, Department of Medicine and Sciences of Aging, University of G. d'Annunzio, Chieti Scalo

[13] Division of Allergy and Clinical Immunology, ASL SALERNO, Hospital of Battipaglia, Salerno

[14] Department of Clinical and Experimental Medicine, University of Parma, Parma

[15] Allergologia e Immunologia Clinica, AO Ordine Mauriziano and University of Torino, Torino

[16] Units of Immunoallergology Azienda Ospedaliero-Universitaria Careggi, Florence

[17] Università Cattolica del Sacro Cuore, Policlinico A.Gemelli, Rome

[18] Division of Pneumology, Spedali Civili di Brescia, Brescia

来源：

Clinical and Molecular Allergy | / 13卷 / 1期

关键词：

Aging; Allergy; Asthma; Therapy;

D O I：

10.1186/s12948-015-0016-x

中图分类号：

学科分类号：

摘要：

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. © 2015 Scichilone et al.; licensee BioMed Central.

引用

共 116 条

[1]

(2014)

[2]

Singh S., Loke Y.K., Risk of pneumonia associated with long-term use of inhaled corticosteroids in chronic obstructive pulmonary disease: a critical review and update, Curr Opin Pulm Med, 16, pp. 118-122, (2010)

[3]

McKeever T., Harrison T.W., Hubbard R., Shaw D., Inhaled corticosteroids and the risk of pneumonia in people with asthma, Chest, 144, 6, pp. 1788-1794, (2013)

[4]

Weatherall M., James K., Clay J., Perrin K., Masoli M., Wijesinghe M., Et al., Dose-response relationship for risk of non-vertebral fracture with inhaled corticosteroids, Clin Exp Allergy, 38, pp. 1451-1458, (2008)

[5]

Suissa S., Kezouh A., Ernst P., Inhaled corticosteroids and the risks of diabetes onset and progression, Am J Med, 123, pp. 1001-1006, (2010)

[6]

Samiy N., Walton D.S., Dreyer E.B., Inhaled steroids: effect on intraocular pressure in patients without glaucoma, Can J Ophthalmol, 31, pp. 120-123, (1996)

[7]

Garbe E., Suissa S., LeLorier J., Association of inhaled corticosteroid use with cataract extraction in elderly patients, JAMA, 280, pp. 539-543, (1998)

[8]

Scichilone N., Pedone C., Battaglia S., Sorino C., Bellia V., Diagnosis and management of asthma in the elderly, Eur J Intern Med, 25, pp. 336-342, (2014)

[9]

Battaglia S., Cardillo I., Lavorini F., Spatafora M., Scichilone N., Safety considerations of inhaled corticosteroids in the elderly, Drugs Aging, 31, pp. 787-796, (2014)

[10]

Gibson P.G., McDonald V.M., Marks G.B., Asthma in older adults, Lancet, 376, 9743, pp. 803-813, (2010)

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