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Biologics for Asthma and Allergic Skin Diseases in Children
Heather Hoch De Keyser1, Bradley Chipps2, Chitra Dinakar3,4
1Department of Pediatrics, Section of Pediatric Pulmonary and Sleep Medicine, School of Medicine, University of Colorado Anschutz, Breathing Institute at Children's Hospital Colorado, Denver, Colorado heather.dekeyser@childrenscolorado.org.
Insights
Biological medications offer new treatment options for children with severe asthma and allergic skin diseases unresponsive to traditional therapies. Pediatric specialists must understand these advanced biologic therapies for optimal patient care.
Area of Science:
- Pediatric Allergy and Immunology
- Pulmonology
- Dermatology
Background:
- Asthma affects millions of children, with a subset experiencing severe disease unresponsive to standard treatments.
- Allergic skin diseases are also prevalent in pediatric populations.
- Biological medications represent an advanced therapeutic option for refractory cases.
Purpose of the Study:
- To evaluate the current literature on biological medications for pediatric asthma and allergic skin diseases.
- To inform pediatricians and subspecialists about the benefits, risks, and practical considerations of these advanced therapies.
Main Methods:
- Review of current clinical literature and guidelines.
- Analysis of approved biological agents (monoclonal antibodies) for pediatric use.
- Evaluation of age restrictions and indications for specific biologics.
Main Results:
- Several biologic agents, including omalizumab, mepolizumab, benralizumab, and dupilumab, are approved for pediatric use with varying age indications.
- These monoclonal antibodies are recommended for severe asthma not controlled by Global Initiative for Asthma steps 4 and 5 care.
- Biologics are also increasingly used for pediatric allergic skin conditions.
Conclusions:
- Biological therapies are a crucial addition to managing severe pediatric asthma and allergic skin diseases.
- Collaborative care between pediatricians and subspecialists is essential for appropriate selection and management of these medications.
- Further understanding of benefits, risks, and implementation is necessary for widespread adoption.
Abstract:
An estimated 7 million children in the United States have asthma, which causes a significant health care burden and affects quality of life. The minority of these children have asthma that does not respond to Global Initiative for Asthma steps 4 and 5 care, and biological medications are recommended at this level in the 2019 Global Initiative for Asthma recommendations. In addition, biologics have been introduced into the care of children with allergic skin diseases. Omalizumab and mepolizumab are approved for children as young as 6 years, and benralizumab and dupilumab are approved for people aged ≥12 years. Reslizumab is approved only for people aged ≥18 years. These monoclonal antibodies may be added for appropriate patients when asthma or allergic skin diseases are not well controlled. Pediatricians and pediatric subspecialists should work together and be aware of the benefits and risks of these medications for their patients, as well as the practical implications of providing these options for their patients. This clinical report serves as an evaluation of the current literature on these types of medications in the treatment of children with asthma and allergic skin disease.
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