Romand P, Kelkel E, Saint-Raymond C, Glas N, Caillaud D, Devouassoux G
Service de pneumologie, hôpital Alpes-Léman, 558, route de Findrol, 74130 Contamine-sur-Arve, France.
Service de pneumologie, centre hospitalier, 73000 Chambéry, France.
Rev Mal Respir. 2016 May;33(5):397-400. doi: 10.1016/j.rmr.2015.07.005. Epub 2015 Sep 4.
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.
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.
Omalizumab is to be considered an effective and well-tolerated therapeutic option for elderly patients with inadequately controlled severe allergic asthma.
随着人口老龄化以及哮喘患病率的上升，这种疾病在老年人中越来越常见。然而，重度哮喘的管理可能很复杂，这是因为65岁以上患者疾病控制不佳的风险增加，部分原因还在于老年的固有特征：合并症、对过敏作用的低估、依从性差、吸入装置使用困难等。
我们报告两例75岁以上患有重度持续性过敏性哮喘的女性病例，她们使用高剂量吸入性糖皮质激素和长效β2受体激动剂治疗无效，随后开始使用奥马珠单抗治疗。使用奥马珠单抗治疗后，观察到发作次数和严重程度减少，哮喘控制得到改善，全身糖皮质激素剂量减少或停用。两例患者对奥马珠单抗的耐受性均良好。
对于控制不佳的老年重度过敏性哮喘患者，奥马珠单抗应被视为一种有效且耐受性良好的治疗选择。
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