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Routine Use of Budesonide/Formoterol Fixed Dose Combination in Elderly Asthmatic Patients: Practical Considerations

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Title: Routine Use of Budesonide/Formoterol Fixed Dose Combination in Elderly Asthmatic Patients: Practical Considerations
Authors: Scichilone, N
Braido, F
Lavorini, F
Levy, ML
Usmani, OS
Item Type: Journal Article
Abstract: Asthma has been demonstrated to be as common in the elderly as in younger age groups. Although no specific recommendations exist to manage the disease differently in older individuals, functional features and clinical presentations may be affected by age per se, and by age-related conditions, such as comorbidities and polypharmacy. In this review article, we aimed to explore the efficacy and safety in elderly asthmatic patients of one of the most currently used inhaled treatments for asthma, that is, the fixed-dose combination of budesonide/formoterol. We attempted to address some practical questions that are relevant to the daily practice of clinicians. We focused on the efficacy and real-world effectiveness of inhaled corticosteroids and long-acting β-adrenergic bronchodilators (ICS/LABA) as treatment in the elderly population, since data are extrapolated from younger populations. We investigated whether a maintenance and reliever therapy approach is more effective in the elderly as opposed to maintenance regimens, from both the general practitioner’s and the pulmonologist’s perspective. To address these questions, we scanned electronic databases (PubMed, MEDLINE, Embase, Scopus and Google Scholar) from the date of inception up to October 2016 with a cross-search using the following keywords: ‘asthma’, ‘elderly’, ‘SMART therapy’, ‘MART therapy’, ‘Turbuhaler’, and ‘budesonide/formoterol’. The available literature on the topic confirms that when the age-associated changes are properly managed in clinical practice, asthma in older populations can be optimally controlled with inhaled treatment including ICS/LABA. This also applies for the budesonide/formoterol fixed combination, thus allowing for the maintenance and reliever therapy approach.
Issue Date: 4-Mar-2017
Date of Acceptance: 1-Mar-2017
URI: http://hdl.handle.net/10044/1/48735
DOI: https://dx.doi.org/10.1007/s40266-017-0449-7
ISSN: 1170-229X
Publisher: ADIS
Start Page: 321
End Page: 330
Journal / Book Title: DRUGS & AGING
Volume: 34
Issue: 5
Copyright Statement: © 2017 Springer International Publishing Switzerland. The final publication is available at https://dx.doi.org/10.1007/s40266-017-0449-7
Keywords: Science & Technology
Life Sciences & Biomedicine
Geriatrics & Gerontology
Pharmacology & Pharmacy
OBSTRUCTIVE PULMONARY-DISEASE
RANDOMIZED CONTROLLED-TRIAL
DRY POWDER INHALERS
RELIEVER THERAPY
LUNG DEPOSITION
SINGLE INHALER
OLDER-PEOPLE
EMPHYSEMATOUS LUNGS
AIRWAY CLEARANCE
PRIMARY-CARE
Geriatrics
1115 Pharmacology And Pharmaceutical Sciences
Publication Status: Published
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine



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