P Romand1, E Kelkel2, C Saint-Raymond3, N Glas4, D Caillaud5, G Devouassoux6. 1. Service de pneumologie, hôpital Alpes-Léman, 558, route de Findrol, 74130 Contamine-sur-Arve, France. Electronic address: promand@ch-alpes-leman.fr. 2. Service de pneumologie, centre hospitalier, 73000 Chambéry, France. 3. Service de pneumologie, hôpital universitaire, 38700 Grenoble, France. 4. Service de pneumologie et d'oncologie thoracique, hôpital Nord, 42055 Saint-Étienne, France. 5. Service de pneumologie-allergologie, hôpital G. Montpied, université d'Auvergne, 63000 Clermont-Ferrand, France. 6. Service de pneumologie, hôpital universitaire de la Croix-Rousse, 69004 Lyon, France.
Abstract
INTRODUCTION: With an aging population and an increase in the prevalence of asthma, this disease is becoming more common in the elderly. Nevertheless, the management of severe asthma can be complex, due to an increased risk of uncontrolled disease in patients over 65 years old and partly to the inherent characteristics of old age: comorbidities, underestimation of the role of allergies, poor adherence, difficulties with inhalation devices, etc. CASE REPORTS: We report two cases of women over 75 with severe persistent allergic asthma not controlled by high doses of inhaled corticosteroids and long-acting beta-2-agonists in whom treatment with omalizumab was initiated. Following treatment with omalizumab a decrease in the number and severity of exacerbations, improved asthma control and dose reduction or discontinuation of systemic corticosteroids were observed. The tolerance of omalizumab was good in both cases. CONCLUSIONS: Omalizumab is to be considered an effective and well-tolerated therapeutic option for elderly patients with inadequately controlled severe allergic asthma.
INTRODUCTION: With an aging population and an increase in the prevalence of asthma, this disease is becoming more common in the elderly. Nevertheless, the management of severe asthma can be complex, due to an increased risk of uncontrolled disease in patients over 65 years old and partly to the inherent characteristics of old age: comorbidities, underestimation of the role of allergies, poor adherence, difficulties with inhalation devices, etc. CASE REPORTS: We report two cases of women over 75 with severe persistent allergic asthma not controlled by high doses of inhaled corticosteroids and long-acting beta-2-agonists in whom treatment with omalizumab was initiated. Following treatment with omalizumab a decrease in the number and severity of exacerbations, improved asthma control and dose reduction or discontinuation of systemic corticosteroids were observed. The tolerance of omalizumab was good in both cases. CONCLUSIONS:Omalizumab is to be considered an effective and well-tolerated therapeutic option for elderly patients with inadequately controlled severe allergic asthma.