Elderly and aged asthma have different characteristics: results of a multicenter study.

Background/aim: Characteristics of asthma in the elderly population is not well-known. The aim of the present study was to evaluate asthma in the elderly population, to compare disease characteristics between patients diagnosed <60 (aged asthma) and ≥60 (elderly asthma) years of age. Materials and methods: The study was a prospective, multicenter, cross-sectional type. A questionnaire was filled out to patients 60 years of age and over, that have been followed for asthma for at least 3 months. Asthma Control Test (ACT), eight-item Morisky Medication Adherence Scale (MMAS-8) was filled out, inhaler device technique was assessed. Results: A total of 399 patients were included from 17 tertiary care centers across the country. Mean age was 67.11 years and 331 (83%) were female. The age at asthma diagnosis was ≥60 in 146 (36.6%) patients. Patients diagnosed ≥60 years were older (p < 0.001), had higher education level (p < 0.001), more commonly had first-degree relative with asthma (p = 0.038), asthma related comorbidities (p = 0.009) and accompanying rhinitis/rhinosinusitis (p = 0.005), had better asthma control (p = 0.001), were using less controller medications (p = 0.014). Inhaler technique was correct in 37% of the patients with no difference in between the groups. Treatment compliance was better in elderly asthma patients (p < 0.001). In the multivariate logistic regression analysis, having well-controlled asthma (odds ratio = 1.61, CI = 1.04-2.51), and high medication adherence rate (odds ratio = 2.43, CI = 1.48-4.0) were associated with being in the elderly asthma group. Conclusion: The characteristics of asthma are different among patients aged 60 years and over which seems to be related to onset age of asthma. In our cohort, the elderly asthma patients had higher education level, and treatment adherence and asthma control was better. Patients diagnosed ≥60 years of age did not have more severe disease.

Adherence to subcutaneous immunotherapy with aeroallergens in real-life practice during the COVID-19 pandemic.

BACKGROUND: The success of subcutaneous immunotherapy (SCIT) mostly depends on regular injections. Our aim was to investigate adherence to SCIT with aeroallergens during the COVID-19 pandemic and demonstrate clinical consequences of treatment disruptions in real life. METHODS: Visual analogue scale for quality of life (VAS-QoL), VAS for symptom scores (VAS-symptom), medication scores (MSs), and total symptom scores (TSS-6) were recorded during the pandemic in 327 adult allergic rhinitis and/or asthmatic patients receiving maintenance SCIT, and these scores were compared with the pre-pandemic data. Patients were grouped according to SCIT administration intervals; no delay (Group 1), <2 months (Group 2), and ≥2-month intervals (Group 3). RESULTS: A total of 104 (31.8%) patients (Group 3) were considered as nonadherent which was mostly related to receiving SCIT with HDMs and using public transportation for reaching the hospital. Median MS, VAS-symptom, and TSS-6 scores of Group 3 patients during the pandemic were higher than the pre-pandemic scores (p = 0.005, p < 0.001, p < 0.001, respectively), whereas median VAS-QoL scores of Group 3 during the pandemic were lower than the pre-pandemic scores (p < 0.001). Median TSS-6 and VAS-symptom scores were the highest in Group 3 compared with other groups (p < 0.001 for each comparison). Median VAS-QoL scores were the lowest in Group 3 compared with Group 1 and Group 2 (p < 0.001, p = 0.043, respectively). CONCLUSION: When precautions in allergy clinics are carefully applied, adherence to SCIT can be high during a pandemic. Patients must be encouraged to regularly adhere to SCIT injections since delays in SCIT administration can deteriorate clinical symptoms.

The effects of mold sensitivity on the clinical characteristics of adult asthmatic patients.

INTRODUCTION: The effects of mold sensitivity on the development and course of asthma have been researched previously, although study results vary. We sought to evaluate the characteristics of our mold-sensitive patients in comparison with those of other adult asthmatic patients. MATERIALS AND METHODS: Data were collected retrospectively from adult asthmatic patients who underwent regular follow-ups at our tertiary care outpatient clinic for immunology and allergic diseases. Patients were grouped and compared according to three categories of aeroallergen sensitivity status determined via a skin prick test. The study variables were demographic data, asth-ma-onset age, comorbid conditions, asthma-related emergency department visits and hospitalizations, systemic corticosteroid burst, asthma control assessment tests, and pulmonary function tests. RESULTS: In total, 242 patients' data were evaluated. Their mean age was 48.6 ± 15.4 years, with female predominance (81.4%). Mold-sensitive asthmatics composed 34.7%, while the aeroallergen-sensitive group without molds (33.1%) and the non-sensitized group (32.2%) composed the rest. The mold-sensitive group had a higher rate of polysensitization (92.8%) than the sensitized group without molds. In multinomial logistic regression analysis, mold sensitivity was positively associated with shorter asthma duration, absence of sinonasal polyposis, presence of allergic rhinitis, and generally well-controlled asthma compared to the non-sensitized group. Also, mold sensitivity was positively associated with shorter asthma duration, drug allergy, and absence of systemic corticosteroid bursts compared to the sensitized group without molds in logistic regression analysis. CONCLUSION: Our mold-sensitive asthmatic patients demonstrated better asthma symptom control. It should be considered that mold sensitization in adult asthmatics is not always a poor prognostic factor.