Comparing asthma treatment in elderly versus younger patients

Area of Science:

• Pulmonology
• Geriatric Medicine
• Pharmacology

Background:

• Elderly asthmatics often present with reduced lung function and increased exacerbation risk.
• Current treatment guidelines for asthma in the elderly require further investigation regarding optimal maintenance and reliever strategies.

Purpose of the Study:

• To compare the efficacy and safety of two budesonide/formoterol maintenance doses in elderly versus younger asthma patients.
• To evaluate treatment response in elderly patients with early- versus late-onset asthma.

Main Methods:

• A randomized, 6-month study involving 8053 asthmatics comparing budesonide/formoterol 160/4.5 μg (1x2 or 2x2 doses).
• Subgroup analysis focused on patients aged ≥ 65 years versus < 65 years, and early- versus late-onset asthma.

Main Results:

• Elderly patients had lower baseline FEV1 and a 55.3% increased risk of severe exacerbations.
• No significant difference in exacerbation rates was observed between the two budesonide/formoterol doses in the elderly.
• Asthma Control Questionnaire (ACQ-5) scores improved similarly across age groups, though not always clinically relevant.

Conclusions:

• Budesonide/formoterol maintenance and reliever therapy is effective and well-tolerated in both elderly and younger asthma patients.
• Treatment response was comparable between elderly patients with early- and late-onset asthma.
• The budesonide/formoterol SMART® approach offers a practical treatment option for diverse asthma populations.