Pediatric problematic severe asthma: Recent advances in management

Area of Science:

• Pediatric Pulmonology
• Allergy and Immunology
• Biomarker Discovery

Background:

• Severe asthma in children presents significant management challenges and high healthcare utilization.
• Difficult-to-treat asthma (DA) and severe therapy-resistant asthma (STRA) phenotypes are recognized, with emerging molecular distinctions.
• The role of airway neutrophils in childhood severe asthma remains unclear, impacting treatment strategies.

Purpose of the Study:

• To review recent advances in objective biomarkers for stratifying and managing childhood severe asthma.
• To identify critical gaps in pediatric evidence for severe asthma management.
• To emphasize the urgent need for efficacy studies in younger children (under 12 years).

Main Methods:

• Literature review focusing on recent advancements in severe asthma biomarkers.
• Analysis of current evidence on novel treatment strategies in pediatric severe asthma.
• Examination of pediatric data limitations for novel therapies.

Main Results:

• Objective biomarkers show promise for improving severe asthma stratification.
• Significant gaps exist in pediatric data, particularly for novel treatments in children under 12.
• Current evidence on airway inflammation markers in STRA shows poor correlation between peripheral and airway sites.

Conclusions:

• Objective biomarkers are crucial for advancing the management of childhood severe asthma.
• There is a critical need for robust pediatric clinical trials, especially for children under 12.
• Further research is required to elucidate the role of neutrophils and optimize novel therapies for severe pediatric asthma.