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Leukotriene Receptor Antagonists for the Treatment of Asthma in Elderly Patients

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Abstract

Elderly asthma (EA) is regarded as a distinct phenotype of asthma and is associated with age-related changes in airway structure and alterations in lung function and immune responses. EA is difficult to diagnose because of aging and co-morbidities, and overlaps with fixed airway obstructive disease. Novel modalities to differentiate between EA and chronic obstructive pulmonary disease (COPD) are necessary. A multifaceted approach, including clinical history, smoking habits, atopy, and measurement of lung function, is mandatory to differentiate asthma from COPD. There are a variety of co-morbidities with EA, of which COPD, upper airway diseases, depression, obesity, and hypertension are the most common, and these co-morbidities can affect the control status of EA. However, leukotriene receptor antagonists (LTRAs) can facilitate the management of EA, and thus addition of an LTRA to inhaled corticosteroid (ICS) monotherapy or ICS plus long-acting β2-agonist therapy improves symptoms in EA patients. LTRA treatment is safe and beneficial in patients who are unable to use inhalation devices properly or who have co-morbid diseases. Therefore, clinical studies targeting a specific population of EA patients are warranted to help achieve a better therapeutic strategy in EA patients.

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Authors and Affiliations

  1. Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Worldcup-ro 164, Youngtong-gu, Suwon-si, 443-380, South Korea

    Hoang Kim Tu Trinh, Ga-Young Ban, Ji-Ho Lee & Hae-Sim Park

  2. Department of Biomedical Sciences, The Graduate School, Ajou University, Suwon, South Korea

    Hae-Sim Park

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  1. Hoang Kim Tu Trinh
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  2. Ga-Young Ban
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  3. Ji-Ho Lee
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  4. Hae-Sim Park
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Correspondence to Hae-Sim Park.

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Funding

This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (HI16C0992)

Conflict of interest

HKT Trinh, GY Ban, JH Lee, HS Park declare no conflicts of interest in relation to the contents of this review.

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Trinh, H.K.T., Ban, GY., Lee, JH. et al. Leukotriene Receptor Antagonists for the Treatment of Asthma in Elderly Patients. Drugs Aging 33, 699–710 (2016). https://doi.org/10.1007/s40266-016-0401-2

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