Dear friends, read new article from last issue of Respiratory Medicine on effects of Omalizumab in asthmatics!
Background
This retrospective study aimed at evaluating long-term effects of Omalizumab in elderly asthmatics in a real-life setting.
Methods
105 consecutive severe asthmatics (GINA step 4–5; mean FEV1%
predicted:66 ± 15.7) treated with Omalizumab for at least 1 year
(treatment mean duration 35.1 ± 21.7 months) were divided into 3 groups
according to their age at Omalizumab treatment onset: 18–39, 40–64
and ≥ 65 years.
Results
Comorbidities,
number of overweight/obese subjects and patients with late-onset asthma
were more frequent among older people. A similar reduction of inhaled
corticosteroids dosage and SABA on-demand therapy was observed in all
groups during Omalizumab treatment; a similar FEV1 increased
was also observed. Asthma Control Test (ACT) improved significantly
(p < 0.001) in the three groups, increasing from 15 [IQR:12-18] to 24
[IQR:22-25] in younger subjects, from 14 [IQR:10-16] to 21 [IQR:20-23]
in the 40-64-year-group and from 15 [IQR:12-16] to 20 [IQR:18-22] in
elderly patients where improvement was lower (p = 0.039) compared to
younger people. Asthma exacerbations decreased significantly after
Omalizumab but the percentage of exacerbation-free patients was higher
in younger people (76.9%) compared to middle aged patients (49.2%) and
the elderly (29%) (p = 0.049).
After Omalizumab
treatment, the risk for exacerbations was lower in subjects aged 40–64
(OR = 0.284 [CI95% = 0.098–0.826], p = 0.021) and 18–39 (OR = 0.133
[CI95% = 0.026–0.678], p = 0.015), compared to elderly asthmatics. Also,
a significantly reduced ACT improvement (β = −1.070; p = 0.046) passing
from each age class was observed.
Conclusion
Omalizumab
improves all asthma outcomes independently of age, although the
magnitude of the effects observed in the elderly seems to be lower than
in the other age groups.
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