Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

Abstract Background This retrospective study aimed at evaluating long-term effects of Omalizumab in elderly asthmatics in a real-life setting. Methods 105 consecutive severe asthmatics (GINA step 4–5; mean FEV 1 % predicted:66 ± 15.7) treated with Omalizumab for at least 1 year (treatment mean duration 35.1 ± 21.7 months) were divided into 3 groups according to their age at Omalizumab treatment onset: 18–39, 40–64 and ≥ 65 years. Results Comorbidities, number of overweight/obese subjects and patients with late-onset asthma were more frequent among older people. A similar reduction of inhaled corticosteroids dosage and SABA on-demand therapy was observed in all groups during Omalizumab treatment; a similar FEV 1 increased was also observed. Asthma Control Test (ACT) improved significantly (p  After Omalizumab treatment, the risk for exacerbations was lower in subjects aged 40–64 (OR = 0.284 [CI95% = 0.098–0.826], p = 0.021) and 18–39 (OR = 0.133 [CI95% = 0.026–0.678], p = 0.015), compared to elderly asthmatics. Also, a significantly reduced ACT improvement (β = −1.070; p = 0.046) passing from each age class was observed. Conclusion Omalizumab improves all asthma outcomes independently of age, although the magnitude of the effects observed in the elderly seems to be lower than in the other age groups.