Background
Older patients with longstanding asthma are more likely to have fixed airflow obstruction so may respond less well to treatment. Clinical trials often exclude elderly patients therefore the effect of age on response to biologics requires further assessment.

Aim
To determine whether elderly patients (EP) with severe asthma respond as well as young patients (YP) to benralizumab.

Method
Patients underwent standard assessment and multidisciplinary team review. Those who had completed a 12-month benralizumab trial (n=24) were retrospectively reviewed. The cohort was split into EP >64y (n=6) and YP <65y (n=18). Data on lung function, number of exacerbations needing steroids, maintenance steroid dose and hospital visits, in the 12-months prior and post starting biologic, was collected and analysed.

Result
Subjective improvement in symptoms was reported in 6/6 (100%) EP and 16/18 (88.9%) YP. No improvement reported in 2/18 (11.1%) YP. There was significant improvement in: Number of exacerbations needing steroids in EP (4.5 to 0, p=0.013) and YP (6 to 1.5, p=0.012); FEV1 in EP (1.74 to 2.355, p=0.019) and YP (1.815 to 2.02, p=0.037) and FVC in EP (3.23 to 3.52, p=0.021) and YP (2.695 to 2.825, p=0.019).

Conclusion
Our cohort of elderly patients treated with benralizumab showed significant improvement in number of exacerbations requiring steroids and lung function. There was no difference in treatment response between the two age groups. Our numbers were small but indicate that patients respond to benralizumab treatment regardless of age. A larger study to evaluate treatment response in patients with varying durations of asthma history would be valuable.