Asthma control in elderly asthmatics. An Italian observational study

Milanese, Manlio; Marco, Fabiano Di; Corsico, Angelo Guido; Rolla, Giovanni; Sposato, Bruno; Chieco-Bianchi, Fulvia; Costantino, Maria Teresa; Crivellaro, M; Guarnieri, Gabriella; Scichilone, Nicola

doi:10.1016/j.rmed.2014.05.016

Cited by 68 publications

(73 citation statements)

References 52 publications

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“…These results are in agreement with those of a recent Italian multicenter observational study conducted in patients older than 65 years with documented physician-diagnosed asthma. The authors highlighted the negative impact of COPD on asthma control [35]. We also found frequent associations with comorbidities that are also more prevalent among the elderly, such as arterial hypertension, diabetes, and psychiatric disorders.…”

Section: Discussionmentioning

confidence: 58%

Asthma exacerbations in a tertiary hospital: clinical features, triggers, and risk factors for hospitalization

Pola-Bibian¹,

Domínguez‐Ortega²,

Vilà-Nadal³

et al. 2017

J Investig Allergol Clin Immunol

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Background: The risk factors for asthma exacerbations are not fully understood. The aim of this study was to determine the epidemiological and clinical characteristics of patients who experience asthma exacerbations. We also assessed potential triggers of exacerbations and possible predictors of hospitalization. Methods: A retrospective, noninterventional cohort study was conducted in adult patients who attended the emergency department of a tertiary hospital with an asthma exacerbation during 2014.

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Section: Discussionmentioning

confidence: 58%

Asthma exacerbations in a tertiary hospital: clinical features, triggers, and risk factors for hospitalization

Pola-Bibian¹,

Domínguez‐Ortega²,

Vilà-Nadal³

et al. 2017

J Investig Allergol Clin Immunol

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“…This pattern is a characteristic of intrinsic asthma with neutrophilic inflammation that may be associated to a more severe obstructive disease and a poor response to treatment (8)(9)(10). In addition, elderly subjects usually have multiple chronic illnesses that can be also associated with poor asthma outcomes (13)(14)(15). Therefore, severe asthma in the elderly may be more serious and thus more difficult to treat in comparison to severe asthma in younger patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

Sposato

Scalese

Latorre

et al. 2016

Respiratory Medicine

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“…© C I C E d i z i o n i I n t e r n a z i o n a l i tion in term of access to the hospital and days of hospitalisation. An Italian observational study (68) explored the level of asthma control in elderly subjects, and factors influencing it. Twenty-nine percent of patients was classified as having ACOS due to the presence of chronic bronchitis and/or CO lung diffusion impairment.…”

Section: Is Acos Worse Than Asthma and Copd?mentioning

confidence: 99%

The asthma-COPD overlap syndrome (ACOS): hype or reality?

Benfante¹

2014

SOB

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SummaryAsthma-COPD Overlap Syndrome (ACOS) has been recently defined as a new pathological entity. Most studies support a large difference in the pathophysiology of bronchial asthma and chronic obstructive pulmonary disease (COPD). However, there is evidence of an increasing prevalence of patients in whom the two diseases coexist or in which one condition evolves into the other, leading to the pathological condition named ACOS. This occurs mainly in individuals with long-standing asthma, especially if also current or formersmokers. Indeed, epidemiological studies show that aging is one of the main risk factors for ACOS, creating the basis for the two entities to converge on the same subject. It is important not to forget the history of asthma, even when the patient develops functional and radiological features suggestive of COPD, because of the therapeutic implications. Patients with ACOS have poorer health related quality of life and higher exacerbation rate then subjects with asthma or COPD alone. Whether ACOS is a distinct nosological entity with genetic variants, or whether it is rather a condition of concomitant diseases that overlap is still a matter of debate. The challenge is to solve this issue. KEY WORDS: asthma; COPD; lung function; airway inflammation; quality of life; acute exacerbations.© C I C E d i z i o n i I n t e r n a z i o n a l i obstruction, chronic obstructive bronchitis and COPD with a reversible component. The crucial question is whether ACOS can be envisaged as a distinct nosological entity, or whether it is rather a condition of concomitant diseases that overlap. This is not a trivial issue, since the diagnostic and therapeutic approaches may considerably vary. If one disease (i.e. asthma) is the driving pathological condition and the other (i.e. COPD) occurs at some stages because of causal factors (i.e. smoking exposure), then the diagnostic procedures should aim at recognizing the primary nosological condition (i.e. reversibility test), and the pharmacological management would therefore follow current guidelines (i.e. inhaled combination treatment). Similar reasoning (with different conclusions) applies when the primary disease is COPD. In this scenario, the "overlap" state is by no means different from other overlapping conditions, such as COPD and sleep apnea syndrome, COPD and bronchiectasis, or asthma and rhinosinusitis, asthma and gastroesophageal reflux. The concept can be extended to extra-respiratory diseases (i.e. cardiovascular diseases) or even physiological abnormalities (i.e. obesity). On the other hand, the identification of a single genetic origin, together with common physiological abnormalities, lead to the description of a new nosological entity, which is not asthma nor COPD, but resembles features of both. The reason why this entity is being increasingly recognized only in recent years could be attributed to the increased life expectancy, since this condition is predominant in the most advanced ages. The challenge is to answer the question of whether ACOS is a hy...

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Asthma control in elderly asthmatics. An Italian observational study

Abstract: Our results highlight the need to specifically evaluate the coexistence of features of COPD in elderly asthmatics, a factor that worsens asthma control.

Cited by 68 publications

References 52 publications

Asthma exacerbations in a tertiary hospital: clinical features, triggers, and risk factors for hospitalization

Asthma exacerbations in a tertiary hospital: clinical features, triggers, and risk factors for hospitalization

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

The asthma-COPD overlap syndrome (ACOS): hype or reality?

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