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Long-term treatment in pediatric asthma: an update on chemical pharmacotherapy
Carolina Vitale1, Angelantonio Maglio1, Corrado Pelaia2
1a Department of Medicine, Surgery and Dentistry, Section of Respiratory Diseases , University of Salerno , Salerno , Italy.
Insights
This review covers long-term pharmacotherapy for pediatric asthma, including inhaled corticosteroids, long-acting beta2-adrenergic agonists, leukotriene modifiers, and omalizumab for severe cases. Future challenges include improving existing drugs and personalizing treatment through subtype characterization.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Immunology
Background:
- Childhood asthma affects 10% of children, being a leading cause of hospitalization.
- Effective long-term management is crucial for symptom control and preventing exacerbations and lung function decline.
Purpose of the Study:
- To review current evidence on chemical pharmacotherapy for long-term pediatric asthma treatment.
- To discuss recent advancements and future directions in managing childhood asthma.
Main Methods:
- Literature review of evidence on pharmacotherapy for pediatric asthma.
- Analysis of control agents including inhaled corticosteroids, long-acting beta2-adrenergic agonists, and leukotriene modifiers.
- Inclusion of biological therapies like omalizumab for severe asthma cases.
Main Results:
- Established long-term control agents are essential for managing pediatric asthma.
- Omalizumab offers a biological treatment option for selected severe asthma patients.
- Personalized treatment strategies are emerging for severe pediatric asthma.
Conclusions:
- Future pediatric asthma treatment requires optimizing existing chemical drugs.
- Characterizing asthma subtypes, phenotypes, and endotypes is key to personalized pharmacological treatment.
- Advanced understanding of severe asthma pathobiology will guide individualized therapy.
Introduction:
Asthma is the most common chronic disease in childhood, affecting approximately 10% of all children, and is the leading cause of hospitalization in developed countries. In this paper we aimed to review the evidence on chemical pharmacotherapy for long-term treatment of pediatric asthma, according to the latest updates. Area covered: Long-term treatment, essential for controlling symptoms and reducing future risks including exacerbations and decline in lung function, includes control agents such as inhaled corticosteroids, long-acting beta2-adrenergic agonists, and leukotriene modifiers. More recent strategies based on the use of a biological drug such as omalizumab, which is a monoclonal antibody directed against immunoglobulin E (IgE), can be considered in selected patients with severe asthma. Expert opinion: In the near future, the challenge of childhood asthma treatment will be to improve the chemical drugs that already exist as well as to carefully characterize the several different asthma subtypes, with special regard to children with severe disease. A better definition of patient features, made possible by the current advanced knowledge of the pathobiology of severe asthma, can ultimately allow the identification of specific phenotypes and endotypes of severe asthma, aimed to personalize pharmacological treatment.