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Difficult-to-treat asthma in childhood

Alexandra Adams1, Sejal Saglani

  • 1Department of Respiratory Paediatrics, The Royal Brompton Hospital London and Imperial College London, London, UK.

Paediatric Drugs
|April 12, 2013
PubMed

Insights

Pediatric severe asthma requires specialist evaluation when standard treatments fail. This review guides pediatricians in investigating and managing difficult-to-treat asthma in children aged 6–16 years.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Clinical Pediatrics

Background:

  • Asthma is a significant global healthcare burden, often manageable with standard therapies.
  • A subset of children experience severe, difficult-to-treat asthma despite optimal inhaled corticosteroid and add-on treatments.

Purpose of the Study:

  • To provide an evidence-based guide for pediatricians managing problematic severe asthma in children aged 6–16 years.
  • To outline a strategy for the investigation and management of severe pediatric asthma in secondary care settings.

Main Methods:

  • Literature review focusing on recent advances in asthma nomenclature.
  • Development of a proposed investigation and management strategy for problematic severe asthma.
  • Emphasis on differentiating true severe asthma from difficult-to-treat asthma due to modifiable factors.

Main Results:

  • Highlights the critical distinction between true severe asthma and asthma masked by unaddressed factors.
  • Proposes a systematic approach to identifying and managing severe pediatric asthma.

Conclusions:

  • Specialist referral is crucial for children with problematic severe asthma unresponsive to maximal therapy.
  • Accurate diagnosis and management are essential for improving outcomes in severe pediatric asthma.

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