Comparing asthma treatment in elderly versus younger patients

A randomised 6-month study compared two maintenance doses of budesonide/formoterol (Symbicort (R) Turbuhaler (R))(h) maintenance and reliever therapy (Symbicort SMART (R)), 160/4.5 mu g 1 x 2 and 2 x 2, in 8053 asthmatics with symptoms despite treatment with inhaled corticosteroids +/- inhaled long-acting beta(2)-agonists. This analysis compared response to the two treatments in elderly patients, >= 65 years, with that in younger patients. Elderly patients with early- or late-onset asthma were also compared. Elderly patients had lower post-bronchodilator FEV1 percentage predicted normal at baseline than younger patients (85.6% vs. 91.0%, respectively). The elderly had more exacerbations and risk of first severe exacerbation was increased by 55.3% (hazard ratio 1.553; 95% confidence interval: 1.249-1.931, p <0.0001). However, no differences in exacerbations were seen between 1 x 2 or 2 x 2 budesonide/formoterol maintenance and reliever therapy treatment in the elderly. Five-item Asthma Control Questionnaire (ACQ-5) scores improved equally in the two age groups. Changes in mean ACQ-5 scores between 1 x 2 and 2 x 2 were significant in both age groups but not clinically relevant (>= 65 years, 0.12; p = 0.018;