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June 24, 2015
Risk of Asthma Treatment Failure Increases With Age
Denver—Age makes a significant difference in the success of asthma therapy, according to a new study that finds the greatest risk of treatment failure in patients 30 and older using inhaled corticosteroids. The research, published online by the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine, sought to determine if age and gender affected therapy response in mild-to-moderate disease. While the study team, led by researchers from National Jewish Health in Denver, finds no significant difference in treatment failure between men and women, they conclude that older age is associated with an increased risk. “Asthma morbidity and mortality are known to be increased in middle-aged and older patients, and gender may also affect the incidence and course of the disease, but the impact of age and gender on asthma treatment response is not well understood,” said corresponding study author Michael E. Wechsler, MD, MMSc, professor of medicine and director of the Asthma Program at National Jewish Health. For the study, researchers looked at Asthma Clinical Research Network data on 1,200 patients—median age 30 years old—participating in 10 trials from 1993 to 2003. While 17.3% of patients 30 and older had treatment failure, that challenge occurred in only 10.3% of those under age 30, according to the results. In addition, a larger percentage of patients 30 and older receiving controller therapy experienced treatment failure. Treatment failure increased for every year above age 30 among patients using inhaled corticosteroids, and those patients, whether their corticosteroids were used alone or in combination with other medications, had more than twice the risk of experiencing a treatment failure compared with the younger cohort, the study points out. Lower lung function measurements and longer duration of asthma were factors in the higher risk of treatment failure, according to the report. “Our novel finding of decreased responsiveness to asthma therapy with increasing age may involve not only biological mechanisms such as differences in the type of airway inflammation in older patients, but may also involve socioeconomic, geographic, or treatment adherence differences between older and younger patients,” said lead author Ryan Dunn, MD, also of National Jewish Health. “Further research is needed to elucidate the causes underlying our observations and to examine whether older patients might benefit from a unique treatment approach.”
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