Severe asthma in school-age children: evaluation and phenotypic advances
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Published on: November 4, 2010
Andrea Coverstone1, Leonard B Bacharier, Anne M Fitzpatrick
1Department of Pediatrics, Washington University, St. Louis, MO, USA.
Insights
Severe asthma in children involves persistent symptoms and inflammation despite high-dose inhaled corticosteroids (ICS). This review covers management, phenotyping, and future therapies for severe pediatric asthma.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Most childhood asthma responds to inhaled corticosteroids (ICS).
- A subset of children experience severe asthma, marked by persistent symptoms and inflammation, even with high-dose ICS and oral corticosteroids.
- Severe asthma in children carries risks of severe exacerbations and significant economic burden.
Purpose of the Study:
- To review current knowledge on severe asthma in school-aged children (6-17 years).
- To focus on recent literature published after January 2012.
- To discuss clinical management, phenotyping efforts, and emerging therapies for severe pediatric asthma.
Main Methods:
- Literature review focusing on severe asthma in school-aged children.
- Analysis of recent publications (post-January 2012).
- Discussion of clinical management strategies and phenotyping approaches.
Main Results:
- Severe asthma is characterized by treatment resistance and risk of adverse outcomes.
- Phenotyping efforts are ongoing to identify distinct subgroups of severe asthma.
- Emerging therapies are being investigated for targeted treatment of severe pediatric asthma subpopulations.
Conclusions:
- Understanding severe asthma in children is crucial for improving outcomes.
- Phenotypic characterization holds promise for personalized treatment strategies.
- Future research should focus on developing and validating targeted therapies for severe pediatric asthma.
Abstract:
Although the majority of children with asthma have a favorable clinical response to treatment with low to moderate doses of inhaled corticosteroids (ICS), a small subset of children have "severe" asthma characterized by ongoing symptoms and airway inflammation despite treatment with high doses of ICS and even oral corticosteroids. Although there is symptom heterogeneity in the affected children, children with severe asthma share the risk for adverse outcomes, including recurrent and potentially life-threatening exacerbations, which contribute to substantial economic burden. This article reviews current knowledge of severe asthma in school-age children (age 6-17 years) with a focus on recent literature published after January 2012. Clinical management approaches for children with severe asthma are discussed as well as current phenotyping efforts and emerging phenotypic-directed therapies that may be of benefit for subpopulations of children with severe asthma in the future.
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