Navigating biologic therapies in elderly asthma

被引:1
|
作者
Ji, Hyein [1 ]
Tan, Laren D. [1 ,2 ]
Hafzalla, George W. [1 ]
Nguyen, Nolan [1 ]
Alismail, Abdullah [1 ,2 ]
机构
[1] Loma Linda Univ Hlth, Dept Med, Loma Linda, CA USA
[2] Loma Linda Univ Hlth, Dept Cardiopulm Sci, Loma Linda, CA 92354 USA
关键词
Asthma; Asthmatics; Elderly; Biologics; Efficacy; Safety; SEVERE EOSINOPHILIC ASTHMA; REAL-WORLD EFFECTIVENESS; INHALED CORTICOSTEROIDS; OLDER PATIENTS; OMALIZUMAB; EFFICACY; MEPOLIZUMAB; MANAGEMENT; SAFETY; BENRALIZUMAB;
D O I
10.1016/j.rmed.2024.107655
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The prevalence of asthma among the elderly population has witnessed a notable rise, presenting unique challenges in diagnosis and management. Biologic therapies, such as omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab, have demonstrated efficacy in targeting specific pathways associated with severe asthma in elderly individuals. However, a significant research gap exists in the application of these therapies in elderly asthma patients. Despite the considerable size of the elderly asthma population and the social and economic burden that this specific demographic imposes on society, the available body of research catering to this group is limited. Notably, no RCTs have been expressly designed for the elderly across all asthma biologic therapies. Moreover, most RCTs have set upper age cutoffs, commonly 75 years old, and exclusion criteria for common comorbidities in the elderly, thus marginalizing this group from pivotal research. This underscores the crucial need for intentional inclusion of elderly participants in separately designed clinical trials and more researches, aiming to augment the generalizability of findings and enhance therapeutic outcomes. Given the distinct physiological changes associated with aging, there may be a concern regarding the efficacy and safety of biologic therapies in the elderly compared to non -elderly adults, posing a barrier to their use in this population. However, observational studies have shown similar benefits of these therapies in elderly individuals as seen in non -elderly adults. Other anticipated challenges related to initiating biologic therapy in elderly people with asthma including dosing consideration and monitoring strategies, which are important areas of investigation for optimizing asthma management will be discussed in this review. In summary, this review navigates the current landscape of biologic therapies for elderly asthma, offering valuable insights for various stakeholders, including researchers, healthcare providers, and policymakers, to advance asthma care in this vulnerable population. We propose that future research should concentrate on tailored, evidence -based approaches to address the undertreatment of elderly asthma patients.
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页数:6
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