Timeless Treatment: The Power of Asthma Biologics at 80 and Beyond (ID 577)
University of Oxford
Abstract
Introduction:
Despite advancements in severe asthma management, elderly patients may encounter challenges in accessing biologic therapies. This study examines the efficacy and tolerability of asthma biologics initiated in patients ≥80 years old at the specialist asthma centre in Oxford.
Methods:
Routinely collected clinical data were analysed to identify patients aged ≥80 years at the initiation of asthma biologics. Patient and disease characteristics were retrieved from the Electronic Patient Record.
Results:
Twenty-one patients were identified, with a mean age of 82 years and 57% being male. Most patients (95%) had comorbidities, including CVD (81%), other respiratory diagnoses (62%), diabetes (19%), or rheumatological conditions (10%). 57% were ex-smokers and 33% never smoked. The majority (86%) had asthma diagnosed in adulthood. 67% had at least one other atopic condition, and 24% had nasal polyps. Geometric mean baseline blood eosinophil count was 0.74×109/L.
Mean baseline ACQ was 2.6, reduced by an average of 1.4 after ~1 year of biologic treatment. Mean pre-biologic predicted % FEV1 was 59%. FEV1 improved by an average of 160mL at follow-up (Table1).
The annualised exacerbation rate decreased from 6.0 per patient in the year before biologics initiation to 0.56 per patient in the year after. At one-year follow-up, 57% of patients were exacerbation-free. Respiratory-related admissions decreased from a mean 0.5 to 0.1 per patient per year. At data collection 19 of 21 patients were alive, with 89% remaining on biologic therapy, all transitioned to homecare delivery. Patient-reported efficacy was highly positive.
Conclusions:
The efficacy and tolerability of biologics in the elderly are comparable to those observed in younger age groups, leading to improved asthma outcomes. These benefits persist despite higher comorbidities and increased frailty within geriatric populations. It is crucial to raise awareness of asthma biologics outcomes in the elderly to ensure their equitable access to these advanced therapies.
Funding: None
Conflicts of interest: None
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