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J Allergy Clin Immunol. 2015 Oct;136(4):848-59. doi: 10.1016/j.jaci.2015.07.007. Epub 2015 Aug 28.

New and future strategies to improve asthma control in children.

Author information

1
Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, Aurora, Colo; Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo.
2
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo; Pediatric Asthma Research Program, Section of Pediatric Pulmonary Medicine, Breathing Institute, Department of Pediatrics, Children's Hospital Colorado, and the Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo. Electronic address: Stanley.Szefler@childrenscolorado.org.

Abstract

Symptomatic asthma in childhood has lifelong effects on lung function and disease severity, emphasizing the need for improved pediatric asthma control. Control of pediatric risk and impairment domains can be achieved through increased medication adherence or new therapeutic strategies. Developing electronic monitoring device technology with reminders might be a key noninvasive resource to address poor adherence in children and adolescents in a clinical setting. In patients who have persistently poor control despite optimal medication compliance, newly emerging pharmaceuticals, including inhaled therapies and biologics, might be key to their treatment. However, barriers exist to their development in the pediatric population, and insights must be drawn from adult studies, which has its own unique limitations. Biomarkers to direct the use of such potentially expensive therapies to those patients most likely to benefit are imperative. In this review the current literature regarding strategies to improve pediatric asthma control is addressed with the goal of exploring the potential and pitfalls of strategies that might be available in the near future.

KEYWORDS:

Asthma; asthma control; asthma exacerbations; biomarkers; dupilumab; inhaled corticosteroids; lebrikizumab; long-acting ß-adrenergic agonists; mepolizumab; omalizumab; reslizumab; severe asthma; therapeutics

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PMID:
26318072
DOI:
10.1016/j.jaci.2015.07.007
[Indexed for MEDLINE]

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