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Severe Asthma in Children: Lessons Learned and Future Directions
1Department of Pediatrics, Emory University, Atlanta, Ga; Children's Healthcare of Atlanta Center for Cystic Fibrosis and Airways Disease Research, Atlanta, Ga.
Insights
Severe asthma in children is difficult to treat, often requiring high-dose inhaled corticosteroid (ICS) therapy. Research shows unique attributes of severe pediatric asthma, but more studies are needed to address remaining knowledge gaps.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Clinical Research
Background:
- Severe asthma in children is a complex, heterogeneous condition posing significant treatment challenges.
- A subset of children with severe asthma requires high-dose inhaled corticosteroids (ICS) and systemic steroids for symptom control.
- These children face increased risks of adverse effects and severe exacerbations, impacting quality of life.
Purpose of the Study:
- To review findings on severe asthma in school-aged children (6-17 years) from the National Heart, Lung, and Blood Institute's Severe Asthma Research Program (SARP).
- To summarize advancements in understanding the clinical, biological, and molecular characteristics of severe pediatric asthma over a decade (2001-2011).
Main Methods:
- Review of data from the Severe Asthma Research Program (SARP) spanning 10 years (2001-2011).
- Analysis of clinical, biological, and molecular attributes of severe asthma in school-aged children.
Main Results:
- The SARP initiative has enhanced understanding of severe pediatric asthma's unique features.
- Despite progress, significant knowledge gaps persist regarding the management and underlying mechanisms of severe asthma in children.
Conclusions:
- Severe asthma in children is a distinct phenotype requiring further investigation.
- Continued research is essential to address remaining gaps and improve treatment strategies for severe pediatric asthma.
Abstract:
Severe asthma in children is a complicated and heterogeneous disorder that is extremely challenging to treat. Although most children with asthma derive clinical benefit from daily administration of low-to-medium-dose inhaled corticosteroid (ICS) therapy, a small subset of children with "severe" or "refractory" asthma require high doses of ICS and even systemic corticosteroids to maintain symptom control. These children with severe asthma are at increased risk for adverse outcomes including medication-related side effects and recurrent and life-threatening exacerbations that significantly impair quality of life. This review highlights findings on severe asthma in school-age children (age 6-17 years) from the National Heart, Lung and Blood Institute's Severe Asthma Research Program (SARP) over a 10-year period, between 2001 and 2011. Although SARP has advanced knowledge of the unique clinical, biological, and molecular attributes of severe asthma in children, considerable gaps remain for which additional studies are needed.
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