Pediatric Mild Asthma: Bridging Current Gaps to Improve Future Care

Pediatric mild asthma is considered a benign condition, yet it accounts for a substantial proportion of morbidity. Characterization and management of children or adolescents with mild asthma are less explored than in adults, particularly due to its heterogeneous nature and variable course. Current definitions of mild asthma in pediatric populations vary across international guidelines or reports, limiting standardization. Although knowledge of asthma phenotypes and endotypes, and risk biomarkers has progressed notably, it is incomplete in the different pediatric age groups exhibiting mild or intermittent symptoms. Moreover, differing treatment recommendations may lead to uncertainty in clinical practice on whether using short-acting β₂-agonist monotherapy or intermittent or daily inhaled corticosteroids or the regimen with inhaled corticosteroids plus bronchodilators combined in single-inhalers.

In this narrative review, we integrated evidence and recommendations from major asthma guidelines and reports complemented by selected insights from recent literature not addressed in these sources.

We summarized the current knowledge of pediatric mild asthma, risk factors for exacerbation, treatment recommendations, and highlighted gaps in clinical practice or questions still unanswered.

In children and adolescents, asthma may seem only apparently mild, mainly due to overlooked or poorly controlled exacerbations. A more unified approach would improve clinical outcomes and reduce its global burden. Priorities include a standardized definition of the mild asthma phenotype in children and adolescents, a detailed examination of risk factors as early predictors of poor outcomes and of the limited access to medications and healthcare resources in low-income countries. Incorporating a broader global health perspective would provide a more comprehensive understanding of the factors influencing the care of children with mild asthma worldwide.