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Future of biologics in pediatric asthma: Optimizing response, early introduction, and equitable access to treatment
Ianthe R M Schepel1, Tina M Banzon2, Wanda Phipatanakul2
1Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Insights
Biologics show promise for pediatric asthma, but research is needed on long-term effects, comparative efficacy, and early intervention to prevent childhood asthma. Equitable access and diverse research participation are crucial for optimal outcomes.
Area of Science:
- Pediatric Pulmonology
- Immunology
- Pharmacology
Background:
- Five biologics are FDA-approved for pediatric asthma.
- Significant knowledge gaps remain regarding their use in children.
Purpose of the Study:
- Evaluate current evidence on biologics in pediatric asthma.
- Identify limitations and future research directions.
- Focus on prevention and equity in treatment access.
Main Methods:
- Literature search of PubMed up to May 2023.
- Prioritization of recent original research and reviews (2019-2023).
Main Results:
- Knowledge gaps include long-term efficacy/safety, comparative effectiveness, and multi-omics for endotype classification.
- Research is exploring early childhood intervention to prevent asthma.
- Biomarker identification for treatment response is an ongoing area.
Conclusions:
- Future research must address long-term outcomes and comparative efficacy.
- Multi-omics approaches are needed for personalized treatment strategies.
- Equitable access and diverse patient recruitment are essential for advancing biologic therapy in pediatric asthma.
Objective:
To evaluate the current evidence, its limitations, and future research directions for the use of biologics in pediatric asthma, with a particular focus on the potential use of biologics to prevent pediatric asthma and equity issues in access to biologic treatment and research participation.
Data Sources:
PubMed articles about the use of biologics in pediatric asthma were searched up to May 2023.
Study Selections:
Recent (2019-2023) original research articles and reviews were prioritized.
Results:
Although there are now 5 U.S. Food and Drug Administration-approved biologics for use in pediatric asthma, there are important knowledge gaps that ongoing research seeks to address, which include (1) the long-term efficacy and safety of using biologics in children, (2) the comparative efficacy of different biologics, (3) multi-omics-based classification of asthma endotypes and phenotypes in children to find potential new therapeutic targets and enable identification and validation of new biomarkers that may predict and help monitor response to treatment, and (4) whether starting biologics in early childhood can modify the natural history of asthma and potentially prevent asthma development.
Summary:
To promote equitable access to biologics and optimize asthma outcomes, future research should recruit patients across the full spectrum of socioeconomic and racial/ethnic backgrounds. Large-scale national and international collaborations between asthma researchers and clinicians are also necessary to fully understand the role of biologics in pediatric asthma.
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