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Severe asthma: When to resort to biological agents
Laura Tenero1, Sara Rossignoli1, Giorgio Piacentini1
1Paediatric section, Department of Surgery, Dentistry, Paediatrics, and Gynaecology, University of Verona, Verona, Italy.
Summary
Severe asthma in children is challenging, but biologic agents like omalizumab offer new hope. Mepolizumab and reslizumab are also emerging options for specific pediatric severe asthma cases.
Area of Science:
- Pediatric Pulmonology
- Immunology
- Pharmacology
Background:
- Asthma control in children typically involves inhaled corticosteroids (ICS).
- Severe asthma affects approximately 5% of pediatric patients, often requiring advanced therapies.
- Biologic agents are considered when conventional treatments fail to control severe asthma symptoms.
Purpose of the Study:
- To review the current landscape of biologic agents for severe asthma in children.
- To highlight the role of omalizumab, mepolizumab, and reslizumab in pediatric severe asthma management.
- To emphasize the potential of targeted biologic therapies based on asthma endotypes.
Main Methods:
- Review of current clinical practice guidelines for severe asthma in children.
- Analysis of approved biologic agents for pediatric use (ages 6-18).
- Discussion of the mechanisms of action and indications for omalizumab, mepolizumab, and reslizumab.
Main Results:
- Omalizumab is currently the primary biologic agent for children (6-18 years) with severe asthma.
- Mepolizumab has recently received European Medicines Agency (EMA) approval for pediatric use.
- Reslizumab is approved for severe eosinophilic asthma in patients over 12 years.
Conclusions:
- Biologic agents represent promising therapeutic options for severe pediatric asthma.
- Treatment selection for biologics should be guided by individual patient endotypes and specific molecular targets.
- The availability of targeted therapies is expanding for managing severe asthma in children.
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