Asthma affects older adults to the same extent as children and adolescents. However, one is led to imagine that asthma prevalence decreases with aging and becomes a rare entity in the elderly. From a clinical perspective, this misconception has not trivial consequences in that, the recognition of the disease is delayed and the treatment postponed. The overall management of asthma in the elderly populations is also complicated by specific features that the disease develops in the most advanced ages and by the difficulties that the physician encounters when approaching the older asthmatic subjects. Asthma in older-age patients presents with specific clinical presentations and may encounter gaps and pitfalls in the diagnostic and therapeutic approaches. A multidisciplinary and multidimensional management of asthma in the elderly is, therefore, strongly advocated.
- Defining Non-T2 Asthma: What are the Mechanisms?
- Best Management Strategy for Non-T2 Asthma
- Obesity & Asthma
Non-type 2 asthma represents about 20-30% of all severe asthmatics. At the present time, there is no specific biomaker that may identify this specific endotype, apart from the absence of type 2 eosinophilic inflammation.; probably, in the next future we would have different biomarkers able to distinguish different subgroups in this large cohort of asthmatic subjects. This endotype may be frequently associated with some comorbidities, like obesity, gastroesophageal reflux of smoking habit). Noneosinophilic severe asthmatics not adequately controlled with the best of the standard therapy may require the addition of other drugs (tiotropium as first additional option, oral theophylline, or long-term macrolide therapy or PDE4 inhibitors). These patients usually respond poorly to oral corticosteroids, but, in any case, this treatment is often used by the majority of the patients, for the lack of significant and effective alternatives.
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