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

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 eld...

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Main Authors:	Scichilone, Nicola, Ventura, Maria T, Bonini, Matteo, Braido, Fulvio, Bucca, Caterina, Caminati, Marco, Del Giacco, Stefano, Heffler, Enrico, Lombardi, Carlo, Matucci, Andrea, Milanese, Manlio, Paganelli, Roberto, Passalacqua, Giovanni, Patella, Vincenzo, Ridolo, Erminia, Rolla, Giovanni, Rossi, Oliviero, Schiavino, Domenico, Senna, Gianenrico, Steinhilber, Gundi, Vultaggio, Alessandra, Canonica, Giorgio
Format:	Online
Language:	English
Published:	BioMed Central 2015
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476207/

id	pubmed-4476207
recordtype	oai_dc
spelling	pubmed-44762072015-06-23 Choosing wisely: practical considerations on treatment efficacy and safety of asthma in the elderly Scichilone, Nicola Ventura, Maria T Bonini, Matteo Braido, Fulvio Bucca, Caterina Caminati, Marco Del Giacco, Stefano Heffler, Enrico Lombardi, Carlo Matucci, Andrea Milanese, Manlio Paganelli, Roberto Passalacqua, Giovanni Patella, Vincenzo Ridolo, Erminia Rolla, Giovanni Rossi, Oliviero Schiavino, Domenico Senna, Gianenrico Steinhilber, Gundi Vultaggio, Alessandra Canonica, Giorgio Review 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. BioMed Central 2015-06-22 /pmc/articles/PMC4476207/ /pubmed/26101468 http://dx.doi.org/10.1186/s12948-015-0016-x Text en © Scichilone et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Scichilone, Nicola Ventura, Maria T Bonini, Matteo Braido, Fulvio Bucca, Caterina Caminati, Marco Del Giacco, Stefano Heffler, Enrico Lombardi, Carlo Matucci, Andrea Milanese, Manlio Paganelli, Roberto Passalacqua, Giovanni Patella, Vincenzo Ridolo, Erminia Rolla, Giovanni Rossi, Oliviero Schiavino, Domenico Senna, Gianenrico Steinhilber, Gundi Vultaggio, Alessandra Canonica, Giorgio
spellingShingle	Scichilone, Nicola Ventura, Maria T Bonini, Matteo Braido, Fulvio Bucca, Caterina Caminati, Marco Del Giacco, Stefano Heffler, Enrico Lombardi, Carlo Matucci, Andrea Milanese, Manlio Paganelli, Roberto Passalacqua, Giovanni Patella, Vincenzo Ridolo, Erminia Rolla, Giovanni Rossi, Oliviero Schiavino, Domenico Senna, Gianenrico Steinhilber, Gundi Vultaggio, Alessandra Canonica, Giorgio Choosing wisely: practical considerations on treatment efficacy and safety of asthma in the elderly
author_facet	Scichilone, Nicola Ventura, Maria T Bonini, Matteo Braido, Fulvio Bucca, Caterina Caminati, Marco Del Giacco, Stefano Heffler, Enrico Lombardi, Carlo Matucci, Andrea Milanese, Manlio Paganelli, Roberto Passalacqua, Giovanni Patella, Vincenzo Ridolo, Erminia Rolla, Giovanni Rossi, Oliviero Schiavino, Domenico Senna, Gianenrico Steinhilber, Gundi Vultaggio, Alessandra Canonica, Giorgio
author_sort	Scichilone, Nicola
title	Choosing wisely: practical considerations on treatment efficacy and safety of asthma in the elderly
title_short	Choosing wisely: practical considerations on treatment efficacy and safety of asthma in the elderly
title_full	Choosing wisely: practical considerations on treatment efficacy and safety of asthma in the elderly
title_fullStr	Choosing wisely: practical considerations on treatment efficacy and safety of asthma in the elderly
title_full_unstemmed	Choosing wisely: practical considerations on treatment efficacy and safety of asthma in the elderly
title_sort	choosing wisely: practical considerations on treatment efficacy and safety of asthma in the elderly
description	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.
publisher	BioMed Central
publishDate	2015
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476207/
_version_	1613238655594266624

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

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