Asthma remission rate in elderly patients treated with biologicals

Introduction:
Bronchial asthma is a heterogeneous inflammatory disease of the airways and occurs in a comparable proportion of older and younger people. In patients with severe forms of the disease, it is possible to extend primary therapy with biologicals. Biologic therapy for asthma has recently been recognized as an opportunity to put the disease into remission state, the criteria for which, however, are not clearly defined. Not all registration studies of biologic drugs include elderly patients, so knowledge of their efficacy and tolerability in this age group is limited.

Material and methods:
The study was retrospective in nature. Available medical records of 75 patients with severe asthma treated with biologic therapy were analyzed. Two age groups were created, where the cut-off was 60 years of age at the time of inclusion. Two time points were analyzed – the 24th and 52nd week of treatment, where ventilatory parameters, peripheral blood eosinophilia, response to treatment on the Global Evaluation of Treatment Effectiveness (GETE) scale and use of oral corticosteroids were measured. Asthma control was assessed by the ACQ (Asthma Control Questionnaire), and quality of life by the mAQLQ (mini Asthma Quality of Life Questionnaire). The incidence of asthma remission was compared between the two groups.

Results:
During treatment at weeks 24 and 52, quality of life and ventilatory parameters improved significantly in the entire group. At both the 24th and 52nd week of treatment, compared to the elderly, the younger subjects showed more frequent normalization of ventilatory parameters and complete remission in the absence of oral corticosteroids, and additionally, at week 52, clinical remission alone.

Conclusions:
The study showed that patients over 60 years of age had a lower rate of complete and clinical remission than younger patients. However, biologic therapy was beneficial in both groups. Therefore, it seems that failure to meet the proposed criteria for disease remission should not influence the decision to discontinue therapy especially in the elderly.