La bronchopneumopathie chronique obstructive (BPCO) du sujet âgé en huit questions/réponses

Efficacy of Umeclidinium/Vilanterol in Elderly Patients with COPD: A Pooled Analysis of Randomized Controlled Trials

“…2 and Online Resource 3 (see ESM). In addition, previous studies have noted that COPD management in elderly populations is associated with specific challenges (e.g., difficulties with inhaler use, inability to generate the required inspiratory flow, cognitive impairment, difficulties in diagnosis owing to the presence of multiple comorbidities) [ 4 , 9 , 17 , 36 ]. Although data on inhaler use were not assessed, the overall findings of this analysis suggest that, in older patients, UMEC/VI is associated with similar or greater absolute (mL) improvements in trough FEV 1 , and a trend for higher percent increases, versus younger patients, and highlight that UMEC/VI can be used with confidence in elderly patients with greater lung function impairment.…”

“…This suggests that UMEC/VI has an acceptable safety profile in elderly populations, and that there are no specific concerns about increased risk of AEs with UMEC/VI as patients age. This is important because elderly patients may be particularly susceptible to AEs [ 9 ]. For example, antimuscarinic agents can cause dry mouth, and potentially result in acute urinary retention in elderly patients [ 9 ], while β 2 -agonists may cause tremor, tachycardia, or hypokalemia [ 40 ].…”

“…This is important because elderly patients may be particularly susceptible to AEs [ 9 ]. For example, antimuscarinic agents can cause dry mouth, and potentially result in acute urinary retention in elderly patients [ 9 ], while β 2 -agonists may cause tremor, tachycardia, or hypokalemia [ 40 ]. Not only can these AEs cause considerable harm to the patient, but they also substantially increase the cost of care for elderly people [ 41 ].…”

“…Not only can these AEs cause considerable harm to the patient, but they also substantially increase the cost of care for elderly people [ 41 ]. The balance between treatment efficacy and safety in elderly patients is further complicated by polypharmacy [ 9 , 25 ]. Data from the US suggest that about one in five community-dwelling elderly people are receiving a drug for one chronic condition that could adversely affect benefit from another drug (e.g., a nonselective β-blocker for hypertension that could counteract a β-agonist for COPD) [ 42 ].…”

“…There is a paucity of data regarding COPD management in the elderly population [ 9 ]. Patients in randomized controlled trials (RCTs) of COPD medications are generally younger than the general COPD population seen in clinical practice [ 11 , 12 ] and are less likely to have cardiac comorbidities [ 13 ].…”